Denervation of the radiocarpal joint

Abstract

Denervation surgery has been a mainstay of our management of chronic pain in the wrist. If there is useful movement at the wrist we prefer denervation to arthrodesis.We have reviewed 22 patients at a mean of 50 months after such denervation surgery at the wrist. This was the only treatment in 16 patients; the other six also had other treatments. Pain was reduced in 16 patients, and 17 were satisfied or improved. None of the patients wished to have a supplementary arthrodesis.We stress the importance of preoperative blockade tests and of a very detailed knowledge of the local anatomy.

Evaluation of proprioception in denervated and healthy wrist joints

“…The level of pain reduction after denervation of the wrist varies. Studies describe painlessness after wrist denervation between 12%–44% with a range of follow-up times between 4.2–9.6 years (Ferreres et al., 1995; Fuchsberger et al., 2018; Grechenig et al., 1998; Hohendorff et al., 2012; Ishida et al., 1993; Radu et al., 2010; Rothe et al., 2006; Schweizer et al., 2006; Simon et al., 2012; Wilhelm, 2001).…”

Innervation of the wrist joint: Literature review and clinical implications

“…Detailed understanding of this innervation is essential for avoiding the undesired denervation of other structures. Many studies show that the main innervation of the palmar side of the wrist comes from AIN, and of the dorsal side from the PIN (Apergis, 2013; Braga‐Silva et al, 2011; Dellon, 1985, 2019; Ferreres et al, 1995; Grechenig et al, 1998; Hagert et al, 2005, 2007; Hixson & Stewart, 1990; Kelleher et al, 1986; Lin et al, 2006; Van de Pol et al, 2006; Wolff, 2012; Wu & Strauch, 2019). The AIN emerges from the posterior surface of the median nerve at different locations.…”