Proximal row carpectomy: Is early postoperative mobilisation the right rehabilitation protocol?

Orthop Traumatol Surg Res. 2010 Sep;96(5):513-20. doi: 10.1016/j.otsr.2010.02.011. Epub 2010 Jun 11.

Abstract

Purpose of the study: To determine the feasibility and interest of an early rehabilitation protocol with no initial immobilisation after proximal row carpectomy.

Material and methods: Thirteen patients were included in this retrospective study. Range of motion (ROM) and wrist strength (grip strength and grasp strength) were evaluated 3 and 6 weeks after surgery on the both wrists (operated and non-operated). Postoperatively, patients had no immobilisation of the wrist, and began a rehabilitation program immediately after surgery in the department of Physical Therapy and Rehabilitation under multidisciplinary team supervision. The same surgical technique was used for all patients by the same surgeon.

Results: Six weeks after PRC, there was a 25-51% deficit in passive ROM and 54-64% deficit in active ROM compared to the corresponding non-operated wrist. Six weeks after PRC, mean overall grip strength was nearly 55% and Jamar dynamometer grip strength was 51% of the contralateral side.

Discussion: This study shows that immediate immobilisation following PRC is unnecessary, and that early rehabilitation is of the essence. Early rehabilitation could reduce the delay necessary to recover range of motion and strength, and probably the time to return to work.

Level of evidence: Level 4, prospective cohort study.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Arthroplasty / methods*
  • Carpal Bones / surgery*
  • Feasibility Studies
  • Female
  • Hand Strength / physiology
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / surgery*
  • Physical Therapy Modalities*
  • Postoperative Care / methods*
  • Postoperative Complications / physiopathology
  • Postoperative Complications / rehabilitation*
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Splints
  • Wrist Injuries / surgery*
  • Wrist Joint / physiopathology