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I started this blog because I needed a proximal row carpectomy and I could not find any further information other than how the operation is performed and statistical results of the operation. I had many questions that were left unanswered. For example, how much pain will I have during the operation, after the operation and how long will it take to heal? When could I start using my hand and more importantly my fingers? Would I be able to ride my motorcycle again? And if yes how soon?

I searched blogs, Bing and Google and could not find any answers to these questions. Of course I could find out what was involved in the operation and during operation including all those gory videos intended for surgeons and horror movie fans. So I decided to start a blog to log events and I urge anyone else who has had a proximal row carpectomy to add their comments or ask their questions to this blog so that it may help others. Additionally please share your experiences as well!

There may be some grammar errors since I’m using Dragon Naturally Speaking software to dictate the entries rather than typing. I hope to catch most of them.

115 Comments
  1. Emma permalink

    Is anyone regretting their decision to have this surgery or does anyone think that they were better off before the surgery. Of those of you who do, how do you cope with the fact that, basically, you have to live with half a wrist?

  2. amber permalink

    Hi Emma, I think that I may speak for most on this forum but I will direct my reply to just myself. I hate this surgery. I hate the pain I am having and the loss of use of my dominate hand. I hate not being able to open simple things, dropping things, not able to get the dog leash snapped on during my agility lessons, not being able to sign my signature like I once could, so many simple things we all took for granted and now has become such an effort. But………… for me and I would think most on here we did not have a choice! when your bone is dead and imploded in your hand you simply cannot ignore it and carry on.

    I will tell you what I wish the doctors would do is to TALK TO US! I am a researcher. I want to know as much as my sponge brain can soak in. I want to know what the surgery is all about, I want to know the downfalls of any procedure, I want to know why a doctor wants to do an “exploratory” surgery after seeing the MRI and XRAYS. Had the first surgeon spent more than his ten minutes with me perhaps he would have been the one to do the operation in the first place.

    When I go up to OHSU in a couple of weeks, my hand surgeon will answer all of my questions to my satisfaction and when I go to a second and third opinion they all will have to give me answers on so many things now that I have suffered through one PRC and face yet another PRC or 4CF or surgery to repair my torn ligament.
    I am sure we all on this forum realize just how important our hands are now that we have lost so much ROM and other problems with them.

    We just didn’t have a choice in the matter is the bottom line.

    • Emma permalink

      I agree with you, the doctors never talk to us. I was left to research for myself and I was only 17, so I think it was a bit too much for me to take in at the time. I wish you luck with your next appointment and I hope you get all the answers that you deserve! Please let us know how you get on.

  3. Kelly permalink

    I had my first post op doctors appointment yesterday. It went great. They did xrays. The bones have shifted down to where they need to be. I’m doing better than my doctor expected, being 25 days post op. I have very little to no pain, 25 days out. Maybe I’m an exception…

    Amber, he said the shooting sensations going to my pointer finger will go away with time. In my case, it’s the nerves and stuff healing and coming back to life. They have been fewer and further between. He didn’t say anything about the 4CF surgery, other than it was not an option for me with stage IV Kienbock’s.

  4. Jennifer Allen permalink

    How long is the recovery time and are you in a cast afterwards? I’m scheduled for this procedure in 3 weeks.

  5. Najat permalink

    Went back on Wednesday for my 1 month and getting my full cast off. They took it off and I am now in a half arm removable cast/splint, still no brace. I was advised to only take it off to bathe and for a couple hours a day for small exercises. I am stiff, swollen and in moderate pain when the splint is off. My thumb seems to feel “disconnected” somewhat, hardly any movement at all since it has been completely immobilized since surgery on November 4th. I go back in 10 days for my next checkup, I am very pleased with my level of care I’m getting from my doctor and staff.

  6. edgard paniz permalink

    Hi Guys i had the surgery 23 years ago, i have no regrets, i get some managable pain when wheather is cold but nothing compare with the pain before surgery. before had a weak wrist due to a never healed scaphoid fracture.

  7. Megan B permalink

    Hi everybody I am scheduled for a PRC for Friday. I also have torn ligaments and excessive fluid build up. I was wondering how long did the procedure take and after your post op visit were you then casted? Hoping for some input please and thanks to all!!

    • amber permalink

      Oh Megan, I was never put into a cast after my PRC. I can’t imagine being casted with the enormous swelling I had, it looked like elephantiasis. Seriously I couldn’t believe this “THING” was my hand it was so hideously swollen and painful! oooooh, ouch! can’t stand thinking about it.

  8. amber permalink

    Hi Megan, best of luck on Friday. I am interested in the torn ligaments. Can you share what the doctor is going to do about that? Will the surgeon do the PRC first then the ligaments? is this in the same hand or what? I really am curious as I think I have a torn ligament in my right hand that I had a PRC done on almost two years ago. I also am pretty sure I have Kienbachs in my left hand as well. Both hands are extremely painful and I can’t figure out how the surgeon will deal with this, which hand will he operate on first? I am in huge despair over this. I hated my PRC procedure, it was a horrid recovery, long and painful and my hand is still so compromised. Months of grueling physical therapy, people that have not had this done do not realize how difficult it is to only have one hand to use for everything and in my case my non dominate hand to boot. I plan to ask my hand surgeon next Tuesday when I see him about alternatives to the PRC which I think the only alternative may be a 4CF. I am inclined to go this route if it will be possible after removing the three proximal row bones.

    I had swelling in my PRC hand for over a year post op, it really sucked and still does to be honest. I did a lot of PT exercises at home with devices that my PT recommended, but I still could not get the fluid to go away.

    Please keep this list informed on the after math and how you come along with time. We all are different and I am hoping beyond hope you fare much better than I did. I am an active, healthy, female that works with my hands for a living so it was really shocking to become so incapacitated all of the sudden, now both hands are shot and I cannot come to grips with it. ( a pun and proud of it!)

    good luck!
    amber

    • Megan B permalink

      Hi Amber thanks again for the reply.. I didn’t see the full message at first. I’m not a hundred percent what the game plan with the ligaments will be but I will definitely update you. Did your doctor have any explanation as to why you had such severe swelling? This is my third operation on the wrist which unfortunately is my dominant hand. My original surgeon did the first two and I now have a new surgeon due to insurance change. My scar is rather uniques and was wondering if this was common. The reason he did the big zig zag (m on my wrist) was for better mobility in the future. Not sure if I can attach in image in here. As for the PRC it was either this or the fusion and the thought of a complete fusion just scares me half to death.. From my Mri he said the lunate was pretty much shot and that its shifted a significant amount which is also the cause for the arthritis covering the wrist .. Hopefully the third times the charm! Hope to hear back soon! One last question how long did your procedure take?? Thanks again ☺️

      • amber permalink

        Nobody could explain why the swelling was so bad except my lymph system just wasn’t working hard enough to move the fluids, my PT gave me plenty of exercises to help things along but it took forever it seemed.

        My surgeon did a beautiful cut into my wrist, I have Keloid scars on my body but the scar on my wrist is barely noticeable. I didn t have stitches and that surely helped with the scarring. He used glue which is awesome for scaring. I got kicked in the face by a horse and the doc then also used glue to repair the hole under my lip where I could stick my finger through to my teeth. Awesome stuff.

        Did your surgeon mention the option of a 4CF instead of a full fusion? I felt the same as you and refused the first hand surgeon that only wanted to fuse my hand. He did not mention a 4CF or I would have considered it. I hate the results of the PRC so much that next week when I go up to Portland to see the surgeon we will talk about doing the 4CF as opposed to the PRC. I have researched this at great length and the end results are so similar and not such a chance of getting arthritis with the 4CF.

        I wish the torn ligament was in the same hand as I can see that maybe they could do both surgeries at the same time. The thought of having to do one, wait for recovery which is months then go through another surgery on the opposite hand is beyond my thought pattern.

        As I have said before, the lunate on my right hand was totally imploded. I didn’t see the left lunate to be in this bad of shape but really I need the surgeon to read the images and tell me where I am at with Kienbachs again. If it will be possible to do the 4CF I think I am going to opt for this since to me nothing can be worse than the PRC and I will then have both procedures to compare recovery with. A full hand fusion is still out of the picture as far as I am concerned, a 4CF is a possibility.

        Good luck, stay with us for updates that I hope you will share. I will be here next week with the results and prognosis of my hands.

        amber

      • amber permalink

        forgot to answer below, the whole operation was about two hours. I insisted on a nerve block because two reasons: first off I wanted to get out of hospital asap as I had a five hour ride home. Secondly and even more important to me was I wanted to watch the entire operation. It was truly fascinating! The only problem I had with the nerve block was that my arm was dead meat for three days. That was really weird, it is like your arm is not attached to your body and just flops around if you are not careful. Very strange but I want to watch again so I will get another nerve block.

        As soon as the operation was over, I got dressed and headed back the 300 miles to home. Cool.

  9. Megan B permalink

    Thanks April! That’s crazy any specific reason why the swelling was so bad? How was overall pain acter and how long would say your recovery was.. This is my third time having surgery on this wrist a result from Keinbocks disease.. My lunate has collapsed and is pretty much shot but the total wrist fusion scared the crap out of me .. Thanks for answering :-)

  10. Megan B permalink

    Please disregard the last comment lol I didn’t get to read your full reply!!

  11. Megan B permalink

    Sooooo much pain along with numbness and pins and needles In my fingers

  12. amber permalink

    Megan, I hope things are going better for you. Please update us.

    I went to OHSU last week and the news was dreadful. On my right hand which had a PRC done two years ago, it is now so riddled with arthritis ( not a torn ligament as I had thought) and the only option I now have is a full hand fusion. This really sucks since the first hand surgeon I went to and was mad at suggested a full hand fusion. That was why I sought OHSU for a second opinion and ended up with the PRC which I hated and now really hate because of the onslaught of arthritis that comes with it. The surgeon at OHSU said this hand needs attention before my left hand which indeed has Kienbachs disease like the right hand did.

    Surgery suggested for the left hand is a procedure known of as a DENERVATION. Does anyone on this forum have any experience with this? It sounds pretty scary and I need a lot more information on this. Since I should have just gotten the full hand fusion in the first place I wondered if I should go ahead and get the double full hand fusion. The surgeon told me he does not want or like doing this because of the total loss of ROM. He does have another unlucky patient with double Kienbachs disease that has insisted on a double full hand fusion but he does not recommend it. the other patient said the pain was just too unbearable and would prefer the loss of ROM to the intense pain.

    The “GOOD” news is that I told the surgeon that I have too much going on until spring and what would happen if I got no surgery for a few months. He said there would be no damage from waiting and if I can take the pain I can put off the surgery. I am going to take the pain and get more information and yet another opinion. Aleve seems to be a big help now.

    I really hope everyone that has had a PRC does not end up like I am with such painful arthritis and the reality of getting a full hand fusion after the PRC. If there is any information on the denervation, please share or direct me to a sight that will give me better information. What I really want to know is if cutting the nerves will make my fingers numb to everything. That is my biggest concern in having this done, but the option of another PRC followed by arthritis, which is common after a PRC is unthinkable to me at this point.

  13. Emma permalink

    Hi Amber

    I had wrist denervation during the PRC surgery, for me, it took about a month and a half to two months to get feeling back in my index and middle finger (the other fingers were not numb at all). However, even though I am 4 1/2 months post PRC, my wrist and the back of my hand are still numb. I am not sure if I will ever get feeling back, but I hope it will come back with time.

    I am experiencing a significant amount of pain in the base of my thumb whenever I move it. Has anyone else experienced this?

  14. amber permalink

    Thank you for sharing this. I am curious as to why the doctor performed both procedures? A PRC and denervation. Can you shed some light on this? How long should the denervation last? do the nerves regenerate with time then you have to have yet another surgery? Gads these wrist problems are huge!

    Emma, I have had pain in the base of my thumb on the post hand surgery since I had the PRC two years ago. The doctor said last week it is due to the arthritis. My pain goes from the base of the thumb down about three inches in the wrist on the Radius side of my wrist.

    Just thinking here of the denervation, I would expect that some where the wrist will be numb until the nerves come back, if they come back. I am most worried about my fingers staying numb. How can you grasp anything if the fingers have no sensation?

    Emma, can you go into more detail as to how your wrist performs since both the PRC and the denevation? How is your ROM? your grip? your movement? I thought that I still had about 35% ROM in my post PRC hand but the doc at OHSU measured it and I only have 25% and that is as good as it will ever get. I can’t believe I am saying this but I now wish I had just gotten the full hand fusion. Also, I asked about a 4CF on my left hand but as I figured, when the lunate is dead and I am at stage 3 in my left hand, there is no bone to attach the plate to. They need the lunate to help anchor the screws, Looks like I am screwed but good. Such is life in the fast lane, eh?

  15. Emma permalink

    My surgeons never told me why they cut my nerves, but I guess it was an attempt to reduce my pain (which it hasn’t) and I have no idea how long the denervation will last, but when the feeling does come back, the last thing I will want is to have another denervation surgery as it was really unsettling for me not being able to feel my wrist and fingers.

    I have a feeling that I have arthritis too, as I had it in my wrist even before my PRC, and I am only 18!. The pain is in the exact same places as you mentioned.

    When my fingers were numb, my wrist was too weak to hold anything, let alone grip anything, so I guess as the feeling came back I was able to do more, but I cannot give you an exact time period for which the feeling starts to come back.

    Shortly after my surgery, I was diagnosed with chronic regional pain syndrome, which has significantly impacted the amount of ROM I have tried to get back, which is unfortunate, but my grip strength is about half of my dominant hand (22kg compared to 40kg).

  16. amber permalink

    Wow. I am almost speechless. First your age is just so young to be suffering like this and the prognosis for the rest of your life is disturbing to me. I feel like a fool whining about my problems when I read about your situation. You have my utter sympathy, Emma. I really cannot even imagine living the rest of my young life into old age with this problem

    I have a big question for you… If you had to have another surgery knowing what you know now, and please include the facts that people that have had a PRC will most likely develop arthritis and this is the gawd awful pain I am having and most likely you too, would you opt for the PRC or the denervation? the doc up at OHSU said the fusion that I should have on my post op hand is now the only option for pain relief. A PRC or denervation is the only option for my left hand. geez.

    What do you think you would do? In hind sight now for me, I would have just gotten the full hand fusion instead of the PRC. that is not an option now for me. But reading your story on the nerve blocks, I am in a quandary.,

    Since my last post, I have contacted two more hand surgeons in my county and the next county over. I want as many opinions as I can get this time.

  17. Emma permalink

    If the same thing were to happen to my dominant hand and I was faced with another surgery, I think I would just have the PRC without the denervation as I am not fond of the numbness. But there was no way I could have had a different surgery as my scaphoid was very damaged due to having no blood supply.

    It depends how damaged your lunate is? You may have to have the PRC if the lunate is very unstable as it would affect the stability of your wrist.

    If only the industry of wrist replacements was more developed, I would have loved to have the opportunity of having a wrist replacement as it might lead to less pain and more movement in the long term.

    Here’s to hoping for the future, eh?

  18. kelly permalink

    Please can anyone tell me if I need an overnight bag or will I go home same day. I’m truely scared 😓 about this operation and so upset that my dominate hand will never be able to fo anything normal ever again. Although its painful with every letter I’m pressing I’m grateful to be able to write for about 30 seconds before I cant continue without breaks… I have no idea how long the surgery is and no idea on which one of two ops they will settle on upon opening me up…. I have had mri x rays bloods u name it steriods tablets had every diagnosis going till they settled on the wrist bones degenerating due to dead bone noone is telling me anything that makes sense anymore.

    • Hi,

      I know it is a scary and awful experience, especial prior to. My operation was under one hour. I went to a Hotel in Toronto and stayed with my wife for 48 hours after the operation before I went back home which was 5 hours away. Normally it is a day surgery but they suggest to stay close by for the first 24 hours in case of any complications. On a better note, things will improve. They will never be perfect but I am certain it will be better than your present situation.

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