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Wrist Replacement vs Fusion vs Proximal Row Carpectomy
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Wrist Replacement vs Fusion vs Proximal Row Carpectomy

I had options for doing nothing and living with the issues I had with my wrist for decades, or having either a wrist replacement, or a partial or full fusion. The choice was mine. I chose the partial wrist fusion over a replacement because I valued limited motion and strength for an active lifestyle more than anything else. I was running out of time for having all options open as my wrist was deteriorating more rapidly than before.

I had a huge cyst in my lunate bone and that issue put things up in the air as far as my choice of a 4 point fusion went. If things looked bad upon entering the area during surgery, I had asked the surgeon to just go ahead and do a full fusion. The lunate bone was an eggshell. Thin and useless for grafting, but a last minute option was presented to me by the surgeon: a Proximal Row Carpectomy.

I had a Proximal Row Carpectomy this morning after it was discovered just how bad the lunate was and how the absence of cartilage between a few bones made for limited choices.

Has anyone else been presented with this option?

there is a video of this procedure on the bottom of this page: http://www.eatonhand.com/vid/prc.htm

I think this was the very best option for me.
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11 Comments Post a Comment
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Avatar_m_tn
I asked for a nerve block after and was given that along with Percopcet of some sort. I have so far experienced very little in the way of terrible pain -- so far.
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Avatar_m_tn
Pain is very manageable and the recovery time is expected to be short compared to the fusion choices.  I understand many docs won't do a PRC for younger patients (under 60), but it was the best choice for me. I expect good ROM (Range Of Motion) and good strength resulting from therapy.

I do not require a constant dose of pain meds. I think a few nerve things were done. Maybe partial wrist denervation. I can't remember everything. I'll get the lowdown during my follow up visit when they take the wire out that is used for alignment. I hope to get images of my crappy lunate that decided the course taken for PRC vs 4 point fusion
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Avatar_f_tn
How has the wrist been this long after surgery? How long after the surgery did you start with therapy. At what point did the pain subside? How soon after did you return to work?

I am 6 days post op from a PRC. Went off pain meds after 4 days but back on as the pain is back. Worried I over extended myself yesterday. What did they do for pain management during therapy?
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1592513_tn?1309027192
I had a PRC 2 years ago, and the pain is HORRIBLE 24/7/365.  I have had an electronic nerve stimulator implanted in my spine and that has helped very little.  My last choice is the total fusion.  I was unaware there was a wrist replacement procedure.  I'd like to know more!
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Avatar_f_tn
I had the PRC surgery done on Jan. 5, 2009 after breaking my wrist the year before.  I had problems with my lunate bone moving out of place. I had very little pain after the surgery and was back at work within 2 weeks.  I do however have a constant ache in my wrist especially if I do too much with it, which is hard not to considering it's the hand I write with.  I have a couple fingers that give me problems every now and then too.  I def would have liked to been given other options, but this was all I was offered.  I'm now learning about the different surgeries they can do and worry I may have to have another one later on.  I was also only 28 at the time of my PRC surgery.  Has anyone else had issues after PRC surgery??????
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Avatar_m_tn
I had a wrist fusion almost 3yrs ago.  Still have a lot of nerve pain which is bearable during the day but wakes me often at night.  Anyone have ideas?  What about a denervation?  
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Avatar_m_tn
I had a wrist fusion almost 3yrs ago.  Still have a lot of nerve pain which is bearable during the day but wakes me often at night.  Anyone have ideas?  What about a denervation?  
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Avatar_m_tn
I am facing PRC and can't find much information from real people that actually had this procedure. It is mostly medical text book stuff that is published. This is the first site I found where real patients are talking. Anyone know of other sites?
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Avatar_f_tn
Hi--Did you have your PRC yet?

I am a 61-year-old woman, mother of 3 and almost grandmother, retired high school English teacher, obsessive runner & weight-lifter, writer, pianist. I went to a doctor 32 years ago because my wrist was hurting and his diagnosis was that my wrist was "boggy." What? Like a cranberry bog? So my Kienbock's progressed and I lived with it until 5 years ago when I finally went to a hand specialist.
First let me make clear that I am only 5 days out of the PRC surgery and so my thoughts and feelings are skewed by pain, medication, frustration, sleeplessness, and, by the way, did I say pain?
I needed this surgery because the lunate disintegration was stage 3B, which turned out to be more like stage 4 once he got in there and had a look. But I had been living in increasing pain for years. Recently I could barely sign my name, dry my hair, push a shopping cart, etc., and it was starting to keep me up at night.
So far, this has been the most painful procedure I ever had in my life. And I've had 3 c-sections, arthroscopic on both knees, breast stuff, thyroid removal, etc.   Was this so painful because so much was going on in there? I don't know. This pain, though---I think this recovery will be measured in weeks, not days. From what I read from other patients on blogs like this one, the results vary greatly. So if you have this procedure done and it hurts a lot more than some people say it will, don't think you're crazy. You're not alone. I should've been overnight in a hospital that first night, no lie. But that is an insurance problem, as we know. Anyway, as I said, it's only been 5 days since my PRC to correct a 60-year-old mess.
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Avatar_m_tn
I have Preiser's Disease of the Scaphoid also known as Avascular Necrosis of the Scaphoid. Even though I am 51 I am very active, I work over 50 hours per week and I work out with weights 5 days a week at the local gym. I have spoken to 2 doctors one in Louisville, Ky and one in Nashville. The one in Louisville recomends the 4 point fussion, the one in Nashville recomends Proximal Row Carpectomy. My surgery is scheduled next week and I am confussed on which procedure would be best for me as they both have pros and cons. Does anyone know which procedure would be better if you are an avid body builder, work over 5o hrs a week doing heavy lifting, I also work the track at MX races. I really need your advice as I do not want to get the wrong procedure and never beable to do the things in life I enjoy doing. Thank you!!
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Avatar_m_tn
I have Preiser's Disease of the Scaphoid also known as Avascular Necrosis of the Scaphoid. Even though I am 51 I am very active, I work over 50 hours per week and I work out with weights 5 days a week at the local gym. I have spoken to 2 doctors one in Louisville, Ky and one in Nashville. The one in Louisville recomends the 4 point fussion, the one in Nashville recomends Proximal Row Carpectomy. My surgery is scheduled next week and I am confussed on which procedure would be best for me as they both have pros and cons. Does anyone know which procedure would be better if you are an avid body builder, work over 5o hrs a week doing heavy lifting, I also work the track at MX races. I really need your advice as I do not want to get the wrong procedure and never beable to do the things in life I enjoy doing. Thank you!!
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