Denervation of the Wrist

Abstract

In a series of 48 painfully restricted wrists denervation was used during a 6-year period on wide indications as a surgical alternative. The observation time averaged 2.4 years. Pain relief occurred in 56% of the patients. Considering the simplicity of the method and the lack of serious complications, it is concluded that denervation of the wrist is worth trying as a palliative measure prior to more extensive surgery.

Salvage Operations for Wrist Ligament Injuries with Secondary Arthrosis

“…Since his original description, several investigators have studied the effectiveness of total wrist denervation, showing generally good outcomes. [4][5][6][7] A recent study of 49 wrist denervations performed for degenerative arthrosis showed pain improvement in 79% of patients, along with improvement in grip strength at 6-year followup. 6 Advantages of wrist denervation are that it does not adversely affect grip strength or range of motion, and does not create problems for future salvage operations.…”

Langzeitergebnisse nach Handgelenkdenervation

“…Ekerot et al [4] fanden bei 46 von 48 Handgelenkdenervationen nach durchschnittlich 2,4 Jahren gute Resultate bei Skaphoidpseudarthrose, Lunatumnekrose, jedoch nicht nach primärer Radiokarpalarthrose. In dieser Studie erzielten die Patienten mit einer posttraumatischen Arthrose nach distaler Radiusfraktur tendenziell bessere Ergebnisse als Patienten, bei denen die Handgelenkdenervation aufgrund anderer Indikationen erfolgte.…”

“…Tab 4. Vergleich der Patienten mit einer Grad-3-Arthrose gegenüber Patienten ohne Arthrose Radiusfrakturen.…”

Denervation of the radiocarpal joint

“…[1][2][3][4][5][6] It can be used for chronic pain, either alone or combined with styloidectomy, osteotomy of the distal radius or ulna, or carpal tunnel release, or as specifically targeted. results with a simplified four-nerve neurotomy.…”

“…Division of the dorsal articular branch of the ulnar nerve is performed through a curved incision over the styloid process of the ulna (4). Where there is widespread pain, the perforating branch of the ulnar nerve may require division through a dorsal incision from the base of the second to the base of the fourth metacarpal (5). The tendons of the long extensors are retracted and the layer of Skin incisions for wrist denervation from (a) the dorsal (the first metacarpal vein is marked by arrows) and (b) the palmar aspects (radial vessels are marked by an arrow).…”