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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.

140 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?

    • Well folks, I am now on my fourth Certified Hand Specialist. In previous comments I learned I am a double Kienbachs patient. the Third hand surgeon sent me up to Eugene Or to a Sports Medicine and Micro- Vascular Hand surgeon. I liked him very much. He spent a lot of time with both of my hands. On the right hand that had the PRC done two years ago this month, my upper carpal bones have shifted downwards where the proximal row bones used to be. I have arthritis in the wrist joint but what is causing me so much pain and lack of ROM is the radius and ulna bone are grinding against the upper carpal bones. So far three surgeons say the only option now for the right hand is a full hand fusion. I am devastated. The reason I went to surgeon number two at OHSU in Portland was to avoid a full hand fusion. Knowing what I am going through now I should have just gotten the full hand fusion three doctors ago. I blame this on the first surgeon not taking the time to tell me that what has now happened is not uncommon with a PRC. So now I am missing the bones and still have to get a full hand fusion. I have opted for now to just bear the pain, and a wise decision because I now have Kienbachs in my left hand. I am going friday of this week, 2-27 -15 to have my left hand hopefully repaired. This surgeon does not think the lunate is totally necrotic and to avoid another PRC, he is going to do a radius shortening osteotomy. He will cut about 3/4 of an inch off the radius bone to open up circulation to the lunate. He said the most frustrating thing with Kienbachs is that there is no predictor for how it will live or die. He said it could just stay like it is now, or it could collapse and crumble like my right hand did.

      Two questions for this forum; one has anyone had this procedure, a Radius Shortening Osteotomy done and how are your results afterwards? Question two and I am going to ask the doctor before this surgery if a Radius Shortening Osteotomy could be done on the right hand to relieve the bones grinding on each other and thus avoid the dreadful full hand fusion?

      I am so sorry I ever got a PRC I have not enough words. My right hand is way worse off than before the surgery even with a collapsed lunate. I have forced myself to become a “lefty” and now with getting my left hand out of kilter for 8 weeks, I have no idea how I am going to perform the simplest of tasks and the most urgent of tasks ie hygiene! If I could opt for anything right now it would be a hook. gads.

      Oh! and to make it even more interesting…. I have Duputrans Contraction in both hands! Ain’t I the lucky gal?

      hoping to get some sort of good news and encouragement.
      amber

  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.

  19. kelly permalink

    Had CRP two weeks yesterday, had a blocker fitted during op to block pain when I came round, this failed and I had a morphine driver fitted.
    I have a stitched up opening which runs about 6cm down top of my hand onto my arm.
    I have a part cast to support bottom wrist and it’s wrapped in bandages, hand was extremely swollen black blue n yellow for first week.
    I have movement in my fingers but due to being casted I’m not sure of the range. However my little finger is extremely numbish with pins and needles which is worrying. This is also milder on my ring finger but nothing on the other three.
    Medication has been codine paracetamol and ibuprofen…..
    I spent 4 days in hospital but it was due to pain control, vomiting and general unwellness.
    During op I also has biopsy of some odd looking skin taken.
    Appointment is in two days to check progres.
    Doctor signed me off work for 6 weeks.

  20. Gary K permalink

    I am typing this email with both hands. I had PRC surgery 24 days ago. I went back to work after two days. I am in a cast, but it begins just below my knuckles. When my fingers began to function after about two weeks, I notice my pinky finger does not work correctly. When I extend all 5 fingers and stretch them outward, it feels normal. But when I try to move my pinky towards my ring finger, it does not move correctly and I cannot touch the ring finger. . When I make a fist, my pinky comes down at a 45 degree angle. When the doctor looked at it, he said the nerve was pinched. But that was 10 days ago and the swelling has all gone down. Has anyone else had this issue?

    • kelly permalink

      Yes I did but after 4 weeks it has settled now and is near on normal x

  21. Denny Strawser permalink

    Today is 03/07/15. I turn 68 on 03/31/15. I am a right handed male. I broke my left wrist when I was 16 years old. I re-broke it at age 18. Both times I received NO medical treatment – mostly because I just believed it was a bad sprain. In 2012 I believed that my knuckles were becoming arthritic and went to my family Dr. who immediately had both wrists & hands x-rayed. It was after veiwing the x-rays he informed me that I had at some time broken the left wrist. It was then I realized that I had broken it twice – which explained the several weeks of pain after those breaks. The pain never really went away 100% – I could always feel some in the wrist joint – also, the most I could ever bend my wrist (backwards) without debilitating pain was 45% – so I learned to avoid doing that! I went into the military at age 20 and of course that meant a lot of push-us which required me to bend that wrist to 90 degrees. Of course that was impossible for me to do so I simply
    make a fist & kept the wrist straight with no bend – that worked well for push-ups. As the years passed I continually had some wrist pain and it became more and more difficult to type. In late summer of 2012 I could tell that the pain was gradually growing more intense – and, remembering what my family Dr. had said regarding the “breaks” I decided to see my orthopedic surgeon. By now it was well into the fall of 2012 and I could no longer type for more than a very few minutes at a time but the most difficult issue was the joint pain at night – I would literally get up and walk the floor until
    the pain dissipated enought to allow sleep. The surgeon diagnosed the problem immediately and explained the surgery to me. In November of 2012 we did the proximal row carpectomy (and carpel tunnel). He forwarned me that this would be a painful rehab. Well, by 2012 I had already had both
    knees replaced (with a rivision on the right knee done 3 years after the fact) and both hips replaced so I thought I knew something about post-pain and rehab. Wrong. It was by some measure the most painful rehap I have ever experienced. Even with oral pain meds (Hydrocodone) I was back to
    walking the floors – this lasted for nearly 3 days. Then the pain began to subside. Looking back on what the surgeon predicted about the pain, I would say he was very accurate. I cannot say that I am completely pain free. I do have low levels of pain (2 or 3 on a level of 10 w/10 being the worst). I do not take any meds for this kind of pain – ever. I do, however, experience level 2-3 when I do extended typing – even this paragraph I feel that level. But, all in all, I have no complaints. I’m very
    glad I had the surgery and all things considered, I would do it again on the right wrist if it came to that.
    Denny

  22. Oliver permalink

    Greetings. I have only been following this blog for a short time but would like to chime in on my recent PRC surgery. It was done on 2/24/2015, Monday will be my first follow up appointment and I’m hoping to have stitches removed. Did anyone have bruising? My fingers and elbow turned dark purple the fingers didn’t surprise me but the elbow did. Im so looking forward to getting this wrap off on Monday I hope they replace it with something a little lighter and smaller. The pain I have is nothing like some of the other writers but it does ache quite a bit with shooting pain. The evenings and bedtime are the worst; it’s difficult to get comfortable enough to fall asleep. I was given a very low dose of Vicodin to take every 4-6 hours and take it to help me fall asleep. My surgery was done as an out patient and with recovery time included took about 4 hours. Thank you.

  23. kelly permalink

    Bruising is totally to be expected, unsure about why ur elbow is bruised but each body is different. I’m UK and on my follow up i was put from a lose half cast Into a full cast and then next appointment was put in a removable cast with pyshio xx

  24. Oliver permalink

    Doctor believes elbow bruising was a result of propping arm up too long, blood pooled down into soft tissue. It has now cleared up. I am also in a hard cast until early April. Looking forward to PT to work on strength and flexibility. Good luck to you! O.

  25. bob davis permalink

    Bob Davis. I had my right wrist done @UCSF 11 days ago, still swelling but improving daily. pain was @5-6 before surgery and is now @1-2. Very glad it’s done as I hade pain for 6 years. PRC =patience, recovery’s coming.

  26. Megan B permalink

    Hi all I had my PRC done on December 12, 2014. I had a Hard cast put on two weeks after the procedure, follow by a splint, and then a brace. It amazes me how I still have so much pain. The doctor and therapist said it was common but now have come to the conclusion that I have extremely bad tendinitis along the base of my thumb so he gave me a shot of cortisone. It definitely helped but now I still have pain. My rotation is horrible, grip nonexistent, and stiffening of the fingers is out of control. Did any of you suffer from all of this? It honestly makes me regret getting the procedure. Thanks, Megan.

  27. kurt permalink

    Bob

    I haven’t pulled the cord yet, but have narrowed my surgeon choice down. He says come and see him when the pain makes me cross that line in the sand. Please keep us informed on your progress. Can I ask a couple questions ?

    Was pain the motivating factor ?
    Has your flexibility, strength, mobility been diminishing through the years ? Do you expect these to improve ?
    How much therapy are you looking at ?
    Do you have problems with the other wrist ?

    Again keep us informed. Thanks

    • bob davis permalink

      Kurt ,Yes pain was a big factor, also age (61). It has been a slow but steady decline, flexibility was good but painful when I pushed to far. The best guess is about 70% return to “normal”. Without hurting all the time, I think it’s a more than a fair trade. Dr. has me on disability till September,total of 6 mo. Not sure how long therapy will take, but in the past I have always done well and been ahead of time. DO YOUR THERAPY!! I have psoriatic arthritis, and yes I can feel the left wrist getting a bit of that, esp. now that it’s taking the full load. Good for you getting to know the Dr. before you commit. San Francisco is a 5 hr .trip for me ,none of the locals wanted to do anything. Well worth the travel to do it right the first time

    • bob davis permalink

      Hi Kurt,
      Was wondering if you had made a choice yet on a PRC? 8 weeks from mine as of 5-14-15. Doing fine but not much strength yet. Frustrating but the pain is 85% gone, that was the idea going into this after all. Looking forward to getting stronger each day. Still glad I did this. Wish you well. Bob

  28. Hi Megan and Kurt,

    As my saga keeps growing, I will answer some of the above questions. I have been to four Hand Surgeons in Oregon, all of them certified in Hands and one, the last one a sports medicine specialist also certified in micro-vascular surgery.

    I have whined on this forum about all the pain I am having in my right hand that had the PRC two years ago last month. I now know why I am having so much pain, the bones of the upper carpal row are grinding against my radius and ulna bone along with severe arthritis. My grip is 30lbs and my flexion is 25%. The Doctor at OHSU in Portland also did a routine deinnervation on one of my nerves along with the PRC, I am told this is pretty common. The ONLY hope now for relief of this pain in the right hand is a full hand fusion. I refused the first surgeon’s services because all he wanted to do was a full hand fusion, that led me up to OHSU, a renowned teaching hospital in Portland OR, that surgeon did the PRC. However he did not mention that at my age, arthritis is most common after a PRC and even for younger patients you can assume you will get this as you age. It is far worse I think post PRC than if I had done nothing. The lunate was necrotic and fragmented. If the first doctor had just explained it all to me what to expect and that the probability of having to get a full hand fusion would be necessary I could have just done the full hand fusion in the first place. I am going to just live with this gawd-awful pain in my right hand until I can’t take it any longer. I drop things all of the time and I dont know if it is just the surgery or the added procedure of deinervation. Very little strength and movement like flexion. Extension is better.

    Now I just had a Radial Shortening Osteotomy in my left hand for Kienbachs disease again although not in stage four. This time I went to the Slocum Center for Sports Medicine in Eugene, OR. this doctor was great spent a lot of time explaining both of my hands and knowing the problems I am having with the right hand PRC, he felt there was some blood supply to my left lunate and doing the radial shortening osteotomy would relieve the pressure and hopefully this will be the end of it. This surgery went so much better I am actually shocked. No swelling ( well very little) fingers all move just fine within 12 hours post op. I was in a half cast for two weeks, internal stitches that dissolved, now a fitted splint for six weeks then back to see the doctor get new x rays and see how it is doing. The procedure entailed cutting my radius bone in half, shaving 3ml off the bone to shorten it and placed a metal plate with 9 screws to the bone. I will have most of my flexion, I have a lot more than right hand even now, 2.5 weeks post op.

    After my PRC on the right hand I was in PT for 3+ months, swelling took almost a year to go away, and I feel I am much worse off now.

    I don’t want to be a bearer of bad news, but I have asked the last three surgeons a ton of questions, I have done a ton of research and all I can tell you is that this PRC is a tricky procedure and the wrist is a very complicated place to do any kind of operation. See what you can do asap and for the rest of your lives to combat arthritis, this is the worst thing to happen to any PRC patient over the long haul. If you get so bad you cant handle the pain your only option is full hand fusion. You will have no wrist movement, think on this as to the implications on the quality of life and doing the most basic things, like toiletry, dressing, eating. It is not good.

    If my left hand gets worse the only option I will have is another PRC and that is as scary as it gets for this sufferer. I cannot get a full hand fusion in both of my hands for obvious reasons. so I look at it as gettin old ain’t for sissies and my hands as far as my future are just shot.

    I am going to donate my body to a teaching university just so they may be able to figure out a better procedure for our wrists and hopefully some younger person will not suffer like I am. I am a pretty tough ol broad, an athlete all of my life and in great physical health other than my hands, so this is pretty much doomsday for me.

    I wish everyone the very best of luck post PRC. I may just be one of those weird cases, nothing new to me!

    amber

    • julie permalink

      I have the option of PRC or 4c surgery n my dominant hand. I already have a ton of arthritis and two torn ligaments. What would you all recommend. Need to decide asap.

      • Depends on what information you are getting from your doctor. Have you asked him how long the four corner fusion will last? will the arthritis become more of a problem that could render you having to go through yet another surgery and what are the options? PRC or Full hand fusion?.Is the arthritis bad enough that a 4CF may not last or even work for the long run? In my case because of the lack of cartilage and the growing arthritis, my PRC was in reality for naught. Because of the necrotic lunate I was not able to have a 4CF on either of my hands. Did you talk to him about a radial shortening osteotomy? If that is an option, that is what I would do.

        If my doctor felt my situation was good enough for the 4CF, I would go with that, if not then ask what are the odds you will eventually end up with a full hand fusion? It is because of my lack of cartilage and the severe arthritis that now, after a PRC, my only option is to live with this pain or a full hand fusion.Had I known all of this before my PRC, I would have opted for the full hand fusion because now I am so messed up with the PRC, and I will have to get the fusion in spite of it. Did your surgeon look into your wrist and see how much cartilage is left? I assume if you have such bad arthritis, you have little cartilage. A big decision, but you really need to get more and as much information from your hand surgeon to make a valid decision.

        Good luck and please keep us informed

  29. bob davis permalink

    18 days from my PRC on my right hand-I’m right handed- still no regrets. I would go with someone who did a LOT of PRC’s. A good friend had a full fusion because of a accident, no pain ,took him a year to adjust to lack of movement. He is still a auto mechanic.

  30. Libby permalink

    I just turned 23 at the end of February and a couple of weeks ago found out that I will need a PRC. First found out about Kienbocks in my left (dominant) hand in August 2013, after being originally diagnosed as a bad sprain six months earlier. My original surgery was a radial decompression with insertion of a vascularized pedicel into my lunate and a terminal branch interosseus neurectomy, done in Sept 2013. I knew going in that a PRC may be inevitable. Because Kienbocks is so poorly understood, treatment methods are difficult to guarantee. I understood this from the beginning, so I’ve kind of been in acceptance of a future surgery since then. Thankfully, I can wait to have the next operation until I graduate college in May and take the MCAT in August. My doctor is optimistic about the upcoming procedure because I’m so young and because I recovered well from the last surgery. He anticipates that the vast majority of my ROM and other function will be conserved. I’ve been having issues with popping/cracking, pain, and transient numbness in my thumb that the dr anticipates will be resolved.

    • Hi Libby,

      Please talk in length with the doctor about PRC vs full hand fusion. I am double kienbachs and had the PRC done on my right hand two years ago. It has been a disaster and now I am faced with yet another surgery and that will have to be a full hand fusion. Had I been better informed I would have done the full hand fusion in the first place.

      I want to tell you about a young fellow I met on another forum, he had the PRC and this was as bad for him as it has been for me. He couldn’t take the pain any longer and ended up with the full hand fusion. This happened several years ago. He also said had his surgeon better informed him of all the future problems he would never have gotten the PRC and would have had the full hand fusion. He said his life is much better, he is an athletic and still competes in his sport.

      I am going next week to see Hand Surgeon # 3 he did not do my PRC, but he referred me to a sports medicine facility 200 miles from me. I just had the end of Feb. a Radial Shortening Osteotomy on my left hand that also has Kienbachs but was still in good enough shape to do the above mentioned procedure, the Radial Shortening Osteotomy has been a huge relief and the recovery was so short I can hardly believe it as compared to the year recovery of the PRC. Actually no recovery, just pain.

      I m seeing surgeon #3 because I think my right hand that had the PRC is fusing itself. I have almost no ROM now as compared to just last January when I first saw him and was measured with 25% ROM. I had no cartilage in the rt wrist, the medi carpel bones have dropped onto the radius and ulna and severe arthritis is grinding bone on bone. IF you have any of these symptoms, I am going to beg you to seek more information. You are very young and the chances for you to get arthritis as you age and thus cause the excruciating pain like I am enduring will be odds on. Then you will face yet another surgery which will only be a full hand fusion. I fought a full hand fusion from Dr.#1 because he just couldn’t spend enough time to explain all the complications of PRC and advantages of a full hand fusion. How I wish I could have had it all explained from the get go to avoid the pain and now look to get the fusion anyway.

      I have seen four certified hand surgeons in the State of Oregon, all of them very good save for #1 who is a good surgeon but didn’t take the time to inform me as he should have. ASK QUESTIONS! get more information and make a well informed decision.

      I wish I could post the films of my hands, I looked at the moderators x rays and mine look nothing like his. I don’t know if we can do PM on this board but if so, email me privately and I will send my x rays for you to compare to your wrist. Good luck!
      thebigaple64@charter.net

  31. Kenny Palmberg permalink

    Hi Everyone,

    Found this blog and just wanted to share my expereince to add to everyone elses. Broke my schaphoid about 5 years ago, but was only diagnosed about 2 months ago as I never followed up, thinking it was a sprain or ligament tear. I just had the PRC done about two weeks ago, and had a large amount of swelling and bruising/discoloration. Was told it normal.

    I am at the point where I can type again, but trying to take it slow. At the moment, my mobility is as bad or worse before, but I start PT tomorrow. I swear I can still slightly fell the specific wrist pain I had from the broken schaphoid, but maybe its too early to tell. I enjoy reading everyone elses experiences, knowledge is power!

  32. Shawn permalink

    Why are there no dates next to the posts to see how current the procedures are?

  33. skarjune@yahoo.com permalink

    Bob,

    Still haven’t decided,but both my brothers have similar wrist issues. They advise to wait on surgery and try exercise. I did and have to say that it has resulted in some improvement. However, my wrist pain is still severe when I bump it the wrong way. Guess I’ll wait it out till the pain is unbearable. Please continue to give progress reports.

    Thanks. Kurt

  34. bob davis permalink

    Kurt,
    Great if the exercise works. I went with the PRC because of a torn ligament and arthritis so exercise just made things worse for me. Have you tried a brace? I got a soft one with a small metal strip under the palm that is comfy but reminds me to watch what I do. Good luck, Bob

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  1. Day 55 – Patience is a virtue… | Proximal Row Carpectomy - PRC

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