Wrist denervation in isolation: a prospective outcome study with patient selection by wrist blockade

Hand Surg. 2011;16(3):251-7. doi: 10.1142/S0218810411005503.

Abstract

Surgical wrist denervation involves division of the anterior and posterior interosseous nerves and articular branches of the superficial radial nerve. In this outcome study, 37 patients were individually assessed and deemed suitable for denervation surgery due to appreciable symptom resolution following a local anesthetic wrist block. At a mean of 18 months following denervation surgery, median activity pain scores had decreased by 60% (p < 0.001) from initial assessment levels, and more than three quarters (30/37) of patients reported continued improvement in their activity pain (p < 0.001). More than two thirds of patients had a satisfaction VAS of greater than 50, with less postoperative resting pain and a greater reduction in postoperative activity pain as the important predictors of patient satisfaction. Thirty-one out of the 37 patients had not represented to our department for revision wrist surgery by a mean of 10.3 years follow-up. We have found this procedure useful in ameliorating symptoms for some patients who would conventionally have required partial or total wrist fusions with greater residual functional limitation.

Publication types

  • Comparative Study

MeSH terms

  • Anesthetics, Local / administration & dosage
  • Carpal Bones / abnormalities
  • Carpal Bones / physiopathology
  • Carpal Bones / surgery
  • Denervation / methods*
  • Female
  • Follow-Up Studies
  • Foot Deformities, Congenital / complications
  • Foot Deformities, Congenital / physiopathology
  • Foot Deformities, Congenital / surgery
  • Hand Deformities, Congenital / complications
  • Hand Deformities, Congenital / physiopathology
  • Hand Deformities, Congenital / surgery
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Nerve Block / methods
  • Pain Measurement
  • Pain, Intractable / etiology
  • Pain, Intractable / physiopathology
  • Pain, Intractable / surgery*
  • Patient Satisfaction
  • Patient Selection*
  • Prospective Studies
  • Stapes / abnormalities
  • Synostosis / complications
  • Synostosis / physiopathology
  • Synostosis / surgery*
  • Tarsal Bones / abnormalities
  • Tarsal Bones / physiopathology
  • Tarsal Bones / surgery
  • Time Factors
  • Treatment Outcome
  • Wrist Joint / innervation
  • Wrist Joint / physiopathology
  • Wrist Joint / surgery*

Substances

  • Anesthetics, Local

Supplementary concepts

  • NOG-Related-Symphalangism Spectrum Disorder