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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.

182 Comments
  1. I had a PRC in 2012 and am going in next month for a 3 year follow up. I’m a potter who throws pottery for a living for past 40+ years. I did rehab well and gained back 110#s of grip strength. My rage of motion is less than it was. My scaphiod bone was toast and I am babying my wrist as to hammering and other trama-only saving its abuse in my clay work.I no longer wedge clay but have a machine for that. I use about 10 tons a tear so I have to take care of wrist-I’m 62. My surgeon Lisa Latanza at UCSF is one of the best in this field.I am hoping not to have a failing wrist and resorting to full fusion. I need some range of motion for clay work.I did rehab very seriously and came back well in 5 months.I did learn some tips and you are welcome to contact me at Liscom Hill Pottery .com if you are considering this surgery.I would get a second opinion for sure as this is not for the weak of heart.The pain is gone but my wrist feels tired a lot and will never be what it once was.For me doing 110% rehab was the key factor
    Mark Cortright

  2. bob davis permalink

    Mark, Dr. Latanza did my wrist also. Right on about the rehab. Glad you are doing well.
    Bob

  3. Emma permalink

    I had a PRC on my left hand (non-dominant) nearly a year ago and I’m only 18! I can safely say that I have not benefitted from this surgery. The pain is a lot worse that before I had the surgery, I have hardly any movement because of the pain. The reason for me having to have this surgery is that my scaphoid was dead and wasting away due to the lack of blood supply. This was caused by the non-union of an earlier stress fracture of the scaphoid. From this surgery I developed CRPS (chronic regional pain syndrome) which is no fun at all! I have been discharged from hand therapy as there was nothing else they could do for me and my surgeon refuses to refer me to a pain clinic to try and help me cope with the pain. It looks like the only other option is a full wrist fusion which my surgeons are not willing to do. So technically I am stuck in no-mans land at the moment.

    On top of all that, I was sent to have an MRI on my right wrist as I started to develop pain in that one. It turns out I have significantly torn my TFCC (the whole central portion) and my scapholunate ligament. I am experiencing increasing levels of pain as well as weakness, so my situation is not ideal. Also, my surgeons refuse to intervene surgically on the right one as they think I am still too young, but it is my understanding that the longer you leave these types of injuries, the worse they get and the harder it is to repair them.

    Has anyone else experienced these types of injuries? If so, I would love to hear how you have overcome them

  4. amber permalink

    Hi again Emma, I am sure you have followed my story. Well I have given in and I am getting a full hand fusion the end of October. I am surprised your doctors are refusing to do this for you. It is the only solution for me now after the PRC which did not turn out well for me. I thought I could live with the intense pain of bone grinding against bone and no cartilage but it just isn’t the pain, it is the lack of strength and that is as bad for me or worse. I just bought a kayak and I don’t have the strength to lift it into my truck bed. For the pain I have to wear my splint 24/7 and it drives me nuts. So I thought what is the difference wearing a splint which is as much movement as a full hand fusion or just biting the bullet and getting a full hand fusion. I fought this idea and I lost, the way I m living is terrible so I don’t think things can get worse. I can only bend my right wrist maybe 1/2 inch if that as it is now.

    Go get another opinion. I have seen four hand surgeons throughout the entire state of Oregon, they all agree at this point the full hand fusion is the only option for me. As I have mentioned before I was in contact with a young BMX enthusiast and he had the same thing, a PRC that went bad and then a full hand fusion, he fought it too but now a few years post fusion he is doing great, regained strength and no pain.

    I will update after my fusion surgery.
    best of luck to everyone,
    amber

  5. Can ANYONE tell me the approx. cost of a proximal row carpectomy?

    • bob davis permalink

      With good insurance I paid $950.00 at UCSF

  6. Kaus permalink

    I am expecting to get PRC soon. This is the only blog that has been helpful. Thank you so much!!!

  7. Pam Blanton-Jones permalink

    My rehab was horrifying ….very painful. I didn’t. Think I would get better. After 2 months, I finally began to have less pain with movement of my wrist. It will get better.

    Hello, I’m a 57 yr old female and my first PRC was on my non dominant hand -left . A year later, I had to have same procedure on right hand. My left hand required 2 surgeries….1st time the full PRC then had to go back in and shave down the bones on the side of my thumb – an impingement had developed. The surgery on my right hand included the shaving of the bones on the side of my thumb, thus eliminating a need for second surgery. I should mention , I never had any kind of trauma on either of my hands. My jobs always required A considerable amount of time on the computer and utilizing calculators. I also handled files and of course lots of paperwork which put stress on my hands/wrist. I also have hobbies of sewing, crochet and jewelry making and in years past I did hair quite a bit.

    I am now 15 years post PRC surgeries. Every now and then after doing household chores or a craft such as sewing or crocheting my wrist will flareup and the pain will last for approximately 4-5 days. I should add that the pain is excruciating . When I do have a flareup, my biggest fear is that I will have to have a fusion in both wrists. However, overall the PRC on both wrist has proven to relieve the excruciating pain I endured prior to the surgeries on both wrists. The only explanation for my circumstances that the doctor could give is that I have Kienbock’s disease, since I had no prior trauma to my wrists. I feel so lucky 😕 I used to love bowling…but not anymore.

    • I was just diagnosed with keinbocks disease. I just had the PRC a few days ago- 1/5/16. I’m in a brace and will need A cast for the next four weeks as well. I heard that this is extremely rare… So I haven’t found anyone that has suffered the same diagnoses. They said that it was the way that my bones grew, so I will need to have my other wrist done in a few months. Post op has been really painful. I thought the pain of a broken wrist was painful but it has not been anything compared to the healing of this surgery. My surgeon is really awesome, she told me everything I needed to know. She also told me this is not a cure-all, because my keinbocks was so far along. I waited too long to have the surgery done, my husband lost his job so we were waiting for our new insurance. She said that it’s extremely wear for someone my age to have this, I’m 27. It’s really cool getting to hear from a few different perspectives on this surgery.

      • Ashley permalink

        Hey Kristen.
        I feel your pain and frustration! I was diagnosed with keinbocks at age 28 wore a cast for months hoping for circulation of blood flow which didn’t work. I had to have radial shortening which worked for only two years- enough time to have a baby. This past September I had to have the PRC- the recovery was extremely painful but less rehab and less time wearing a cast than radial shortening. I am going on four months post op and can honestly say o don’t have much pain at all. My arm and hand still looks a little deformed because I haven’t built my muscle mass up yet. I had a great report last apt and do not have to go back which is a wonderful feeling! Good luck and it will get better.

      • Tasha permalink

        I have late stage kienböcks and am 23. I am in great health otherwise and so having a very specific procedure done to try and repair the lunate bone, if possible. If not possible, (due to degeneration between bones and cartilidge) I will be waking up with a proximal row carpectomy instead. I am trying to find out if anyone who has had a PRC is aware of what the full, out of pocket expense for their procedure would have been. I am having a tough time with insurance, and am over a year due for this operation. I thought I had done all my homework and worked everything out, but turns out my insurance and the hospital made in error in assuming the surgery would be covered. I am now looking at having to pay 50% of this procedure if I cannot find another insurance that will cover this on such short notice. I am aware that costs differ greatly depending on where and whom you have your surgery with. I am going with a very experienced surgeon in Irvine, Ca and expect it to be on the higher end of the spectrum. :/ if there is anyone who might have any sort of information, I’d love to hear it. My surgery coordinator is trying to get a number for me but it may take her a little while, and a second reference always helps. I need to figure what I can do to finally have this taken care of. Thanks

  8. Debbie permalink

    Hi Tasha, I’ve had a PRC back in 2008 but it wasn’t due to Kienbocks but I’m wondering if there is a possibility you could be covered under your parents health care. I believe you can be covered under their insurance until you are 26 years old. I’m just not sure about the ruling if you have your own insurance but if you have to pay for your own insurance you might be able to be covered under your parents. This also applies to married children. You may have already checked this out but food for thought. Sorry about you having to go thru this at such a young age. Debbie

  9. Tasha permalink

    Debbie, I do appreciate the advice, and it is good to hear from someone who has already been through this procedure. However, you are mistaken in assuming that this is an option for me. One of my parents lives abroad and while the other lives in the states, he does not have insurance, nor have I ever been able to depend on him for anything as he is not a reliable or a responsible individual. Even if he had insurance, it does not necessarily mean that they would cover the specific doctor and operation that I need. I have insurance that would most likely cover a carpectomy with another surgeon within my network.. But I am looking to have a different operation done, with a surgeon that is unfortunately out of network.

    It is a little bit complicated, in that I am seeing this particular doctor to do an unusual procedure (a vascularized bone graft to the lunate) but there is a chance that during surgery, they may be unable to repair the lunate and instead have to perform a PRC. This is the case for why I am seeking any information possible regarding expenses, so that if I am unable to find reasonable coverage with another plan at this time, I can at least have a possible idea of what to expect in costs, in regards to a PRC. If you have any idea, it would be a great deal of help as far as peace of mind goes.

    I wish there were more information available for these sorts of things! Thanks to anyone who has advice or an idea of what to expect, no matter how broad your guess may be.

  10. Debbie permalink

    Hi Tasha, I am sorry I came across as assuming your parents would have health insurance for you. I was trying to think of an option that might be helpful but unfortunately that is not the case. I completely understand that you want to try everything possible before having the PRC. I was 49 when I had my PRC and that was due to an injury. I can’t imagine being 23 and facing losing partial hand function. I have had a good outcome with my surgery but it was a very long recovery process. It was actually 15 month post op before I felt relief. A good support system is a great thing to have but you seem to be to be a very intelligent and driven to do the best for yourself. Health insurance should not be this difficult and we should be able to all receive health care with any doctor! I wish you the best of luck with your procedure and I really hope they can get the procedure covered under your insurance so that your out of pocket expense is minimalized.

  11. Emma permalink

    Hi everyone. I had a PRC on my left wrist 18 months ago when I was 17. Unfortunately, the capitate didn’t rest in place properly and has developed very severe arthritis. I only found this out after getting a second opinion as my surgeons who did the surgery told me that everything had settled in place fine and didn’t really understand why I am still having severe pain in the wrist joint. Because of this problem, I have to have a total wrist fusion meaning I will never be able to move my hand/wrist again. I can’t believe this is happening and I’m only 19! It is a lot to get my head around, but I would love to hear if other people who have had this revision surgery are better off now having had it?

    • Mike permalink

      Sorry to hear you’re having these issues so young. I’m in the exact same situation. However, I’m in my 40’s. I ruptured my scapho-lunate ligament on my left hand in 2002 and on my right hand in 2005. Two separate incidents. Had multiple reconstructive surgeries on both. The last one on my left was done in 2003 with the hopes of getting ten years out of it before total fusion. Had a PRC in April 2015 with the hopes of extending it a few more years, but the cartilage has warn away completely. Much quicker than they thought it would. The pain is extreme 24/7. Looked into a total wrist replacement speaking with the creator of this surgical procedure who is out of Houston, TX. Unfortunately, my surgeon and I were not aware that you can’t have a wrist replacement following a PRC. Only option is a total fusion. So that’s where I’m heading. Took me months to come to grips with fusing my wrist, but compared to wear it’s at now following the PRC the motion won’t be much different and the pain is suppose to be 100% gone. I’m currently at 20 degrees ROM and zero strength. Very difficult to even turn a door nob. Met with several surgeons throughout Southern CA and they all said the same thing-with a total fusion once it’s healed the pain is gone.

      Looking to go to Houston later this year or early next year for a wrist replacement on my right hand. Both wrists are extremely painful 24/7 and limit my capabilities tremendously. Just trying to deal with each wrist one at a time.

  12. Emma permalink

    So much surgery! It also turns out that I have a torn scapholunate ligament and centrally torn tfcc on my right with severe arthritis and ulnar impaction syndrome. All of this probably occurred through overuse from hardly being able to use my left wrist. However, when I have the fusion, I will have to rely more on the right which is going to damage it even more. I am just afraid that the same thing will happen to the right as it did to the left :/ I’m right handed and a student at uni and I am already struggling with note taking and concentration during lectures due to the pain. I just hope these problems won’t affect any more of my uni life!

    • Mike permalink

      From someone who has gone through this with both wrists….my suggestion to you is if you’re left wrist has some mobility and you can live with the current pain for another six months then fix the right wrist first. Let it heal completely and then fuse your left. If you’re right isn’t completely torn it ultimately will so I’d definitely address that first if you can.

      • Emma permalink

        I would love for my surgeons to fix the right one first but they refuse to do it because apparently the left is quite unstable (risk of dislocation). To be honest I don’t think I can cope with the pain in my left wrist for much longer, it is very depressing. The ligaments in the left are completely torn but they just keep failing to address it!
        For example, the last time I saw my original surgeons they initially said ‘we need to do arthroscopy on the right’. They sent me for an X-ray and when I came back they said they definitely didn’t want to do anything and there was nothing else they could offer to help me.

      • Mike permalink

        Just make sure you’re getting multiple opinions. Don’t worry about offending the surgeons by asking for your records to have others look at it. Doesn’t mean you’re not going with them, but given the seriousness you want multiple opinions. Once you have the fusion and it heals you should feel much better. Best of luck with everything.

      • Amber applegate permalink

        Hi Emma,
        If you have been following my story here, you know I am bi lateral Kienbachs. I had PRC two years ago and suffered from the results of that for almost two years. I had a Radial Shortening Osteotomy on left Hand one year ago and that surgery was a great success. I thought I could live with the pain in my right hand since the PRC, but not only was the pain so unbearable but I lost so much ROM, to the point a fusion would not impede me any more than what I was experiencing. I bit the bullet last October and had my right dominate fused. OMG! I never even took a pain med after the surgery! It was such a relief to be pain free. I wore a splint after the half cast was removed at twelve days post op for a month. I cannot tell you how much better my life is now! I never even think about my fused hand, not only was it instant relief, but I am finally getting my strength back. I stack firewood, lift heavy objects, I can do it all! My handwriting is the only thing that seems a bit difficult but that is so minor!. For someone that fought fusion so strongly, all I can say is I wish I had gotten more information on a fusion and avoided two years of pain, frustration and ending up getting what I should have gotten in the first place. I can’t wait to finally be able to lift my kayak up on its trailer all by myself! I m very pleased. Best of luck to you!
        Amber

      • Emma permalink

        Hi Amber,
        Yes I have been following your story :) Wow! What a great outcome to the total fusion! It is great to hear you are doing so well! I guess there wouldn’t be much difference in terms of movement as I don’t have much now, and to hear that you are now pain free is really encouraging to me. Thank you for replying!

  13. Emma permalink

    Thank you I will make sure. Best of luck to you too :)

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