SLAC Wrist: Proximal Row Carpectomy
Proximal row carpectomy (PRC) is performed in the setting of symptomatic wrist arthritis to alleviate pain at the expense of wrist motion and grip strength. By removing the proximal carpal row, a new radiocapitate articulation is created. Traditionally, well-preserved cartilage on the head of the capitate was a prerequisite when considering a PRC as a treatment option. Currently, if there are mild arthritic changes of the proximal pole of the capitate, a capsular interposition flap can be used as a soft tissue barrier. Care should be taken during surgery to preserve the radioscaphocapitate ligament and ensure that the capitate is articulating in the lunate facet of the radius. Due to the concern for development of radiocapitate arthritis over time, PRC should be used with caution in patients under 35 and in manual laborers.
