Denervation of the Wrist Joint and Its Long Term Effect

Abstract

Background: The wrist joint is a common site of traumatic, degenerative and inflammatory disease that, when symptoms are severe, can be treated by partial or complete arthrodesis, arthroplasty and/or wrist denervation. Aim of the Work: to review systematically studies about total and partial wrist denervation for chronic painful wrist conditions and meta-analyze the long term improvement. Materials and Methods: Literature searches was conducted using the following databases: "PubMed, Ovid, Web of Science, Science Direct, Scopus, Cochrane Library, Google Scholar, Medline" using the following key words: wrist joint, total denervation, partial denervation for published studies. Results: This study provides long-term data regarding the outcomes of partial and total wrist denervation. We have found that this is a reliable motion preserving procedure for patients with chronic wrist pain. In the series, 85% and 70% of patients did not undergo revision surgery at average follow-up of approximately 54.7 months and 47.5 months in total and partial denervation respectively. Conclusion: Denervation is a relatively quick procedure with low complication rates and does not preclude salvage procedures if pain persists. It has been shown that neurectomy of the articular branches is possible without any injury to the important sensory and motor nerves of the hand. Total denervation of the wrist is a useful method for treating wrist pain when other choices compromise functional capacity or a long period of post-operative recovery is not desired.