June 20, 2024

Proximal Row Carpectomy (PRC) is the reconstruction procedure for the post-traumatic degenerative condition in the wrist however it is indicated in some acute conditions also.

Proximal Row Carpectomy
Proximal Row Carpectomy

Especially in lunate and Scaphoid arthritis, this PRC is performed

Nonunion of the scaphoid and Keinbocks disease are some common indications

PRC is used as an alternative to arthrodesis who needs function but can tolerate some degree of pain

It will give satisfactory relief of pain/preservation of motion

PRC is a motion-preserving treatment for the degenerated wrist which provides a painless wrist range of motion with few complications

So, it is indicated in the patient who

  • Have limited requirement
  • Desire some wrist mobility
  • Possibility of minimal persistence of pain

If it fails, we need to go for ARTHODESIS

Manual laborers are the best candidates for Proximal Row Carpectomy (PRC)

Excision of the triquetrum, lunate entire scaphoid usually is recommended in PRC

In degenerative changes for doing PRC, a healthy articulating surface should be present in radial (Lunate fossa) and capitate ( Proximal articulating surface)

Indications for primary PRC

  1. Severe open carpal fracture-dislocation by disruption of bony architect
  2. Comminuted fracture of scaphoid and lunate
  3. Disruption of blood supply of lunate and scaphoid
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