Total Wrist Denervation: Survival Study and Functional Outcomes

University Hospital, Brest63 enrolled

Overview

The purpose of the study is to evaluate the long-term effectiveness of total wrist denervation on pain by assessing the surgery survival. The residual functional wrist's quality and the patients' satisfaction will also be evaluate.

The degenerative diseases of the wrist are numerous and include both post-traumatic osteoarthritis lesions and inflammatory diseases. In any case, one of the main reasons for consultation is pain. In case of inefficiency of a well-conducted medical treatment (splints, anti-inflammatories, infiltrations), surgical management remains difficult because of the multitude of treatments that can be offered: partial or total arthrodesis of the wrist, prosthetic arthroplasties, pyrocarbon implants or proximal row carpectomy. But these treatments are heavy and can potentially be sources of complications such as stiffness, loss of strength or progressive wear of the implant. Total wrist denervation is an alternative since 1966. The original technique follows an anatomical study of the innervation of the upper limb. This technique has been proven to significantly improve pain without major after effects. Several teams demonstrated a decrease in pain associated with conserved strength and mobility, but few studies have studied the long-term results of this technique, especially on the absence of residual pain. The purpose of this study is to evaluate the long-term effectiveness of denervation on pain by assessing the surgery survival, the residual functional wrist's quality and the patients' satisfaction.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Wrist Arthritis Survival

Interventions

Total wrist denervationPROCEDURE

Study of the files

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * patient undergoing total wrist denervation between January 1995 and December 2013 at Brest CHRU, performed by the same senior surgeon Exclusion Criteria: * patient who had another intervention at the same time (confounding factor) * refusal expressed by the patient to participate in the study

Locations (1)

CHUR de Brest

Brest, France

Outcomes

Primary Outcomes

survival over time

duration (in years) of absence of surgical revision, and residual pain \< or = 3 on a pain numerical scale (0 to 10, WHO criteria for mild pain)

Time frame: from date of surgery until the date of first documented failure (surgical revision; pain > 3), assessed up to the inclusion date

Secondary Outcomes

surgery survival over time

duration (in years) of absence of surgical revision

Time frame: from date of surgery until the date of documented failure (surgical revision), assessed up to the inclusion date

residual pain

numeric pain rating scale (between 0 to 10; 0 equal no pain; 10 equal "worst pain imaginable")

Time frame: at the inclusion date

residual functional wrist's quality

Result of the DASH (Disabilities of the Arm and Shoulder Disabilities) score (between 0 to 100; 0 equal better result; 100 equal worst result)

Time frame: at the inclusion date

patients' satisfaction (1)

analogue scale between 0 to 10 at the last follow-up (0 equal minimum; 10 equal maximum)

Time frame: at the inclusion date

patients' satsfaction (2)

answer to "would you repeat this procedure again?"

Time frame: at the inclusion date

Data from ClinicalTrials.gov

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