La dénervation totale du poignet : une étude rétrospective de 27 cas au recul moyen de 77 mois Complete wrist denervation: A retrospective study of 27 cases with a mean follow-up period of 77 months

AbstractObjectives. – Complete wrist denervation is a palliative operation, which yields still controversial outcomes. The aim of our study is to assess thelate outcomes of complete wrist denervation.Methods. – In a retrospective continuous review of 27 complete and isolated denervations of the wrist joint performed by the same surgeon in 27patients (15 men for 12 women) from 1995 to 2007, the pain (VAS), the function (Dash-score), the range of motion, the strength (Jamar) and theradiological changes were assessed at a mean follow-up period of 77 months (12 to 157).Results. – At final follow-up, 12 patients (44%) were completely free of pain and 11 (41%) had little pain, four (15%) had moderate and severepain. The average time to achieve the complete pain relief was 3 months and 3 weeks. Pain relief was stable over time in 89% of cases. There was asignificant improvement in range of motion: 118flexion/extension; 88pronosupination. In average, the Jamar grip strength was 85% of the healthyside. The Dash-score was in average 30.4 (22 to 60). The extension of the osteoarthritic surface was observed in 14 patients (52%). Sixcomplications were noted: one complex regional pain syndrome, five neuromas four of which resolved spontaneously. Two patients were re-operated. Eighteen patients were very satisfied (67%), six patients were satisfied (22%) and three patients were moderately satisfied (11%).Disponible en ligne surwww.sciencedirect.com