Proximal Row Carpectomy

What is proximal row carpectomy?

There are eight small carpal bones in the wrist, four in each row. In people with severe arthritis, the cartilage that covers these bones and allows for easy and comfortable movement has worn away. When bones no longer have this protective covering, they may rub together, causing pain and stiffness. If other therapies have not helped relieve your pain, your doctor may recommend a motion-sparing surgery called proximal row carpectomy, which involves removal of several carpal bones in the wrist to prevent painful, bone-on-bone friction.

"Proximal" refers to bones that are closest to the body. Thus the proximal row of wrist bones consists of those that are furthest away from the hand and closest to the elbow. The four bones are the scaphoid, lunate, triquetral and radial styloid. A proximal row carpectomy (removal of carpal bone) usually involves removal of the first three. Removal of these bones frees up space around the other wrist bones and stops the bones from rubbing one another. While this procedure relieves pain and still allows for mobility of the wrist, it does significantly change the structure of the wrist and may affect motion and grip strength.

Your doctor can discuss the different wrist surgery options and help determine whether proximal row carpectomy is the right surgery for you.