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Questions/Answers

Doctor Steve McCabe at the Toronto Western Hospital has agreed in principle to answer some questions that people may have about proximal row carpectomy. Many of the questions may be given to his staff since he runs a teaching hand clinic.

Please note that no questions concerning diagnostics can be answered since the doctors would require an examination and perhaps x-rays and other tests before they could make any type of diagnostic comments. Therefore the questions that can be answered are general questions about a proximal row carpectomy. Doctor Steven McCabe has given no guarantee that any or all questions will be answered however I will be sending these questions to him once every week. I think it’s only fair that I submit one or two questions per week since Doctor Steven McCabe is a very busy Doctor. If you have any questions about a proximal row carpectomy you may submit it to my email address at Peter.Sanderson@Outlook.com with the subject matter “PRC Question”. I will review these questions and if they are not of a diagnostic nature I will choose to do week to submit to Doctor Steven McCabe.


Question: During he PRC procedure, is it necessary to move or relocate tendons?

Answer: Yes, they must be moved out of the way to access the bones and then are placed back in position.


61 Comments
  1. Demi Richens permalink

    I’m not sure if this has already been asked, but I’m have a PRC in June on my non dominant hand and I was wondering if anyone can tell me how long they took off work?
    I work an office job so they most straining thing I do is typing and filing paper work.
    Any ideas on how long I will need off?

  2. Don Marius1 permalink

    guys, Im guessing it depends on the body and maybe some more factors. Me, I did not got any colour at my fingers or bruising type. Just inflamed hand, not fingers, just the wrist. My inflamation was on the back of the palm and where the scaphoid was. (my 1st problem from the start)
    So Im guessing, thoose bruises may be signs that some area is damaged more, depend on what the surgeon did there.

    If its a simple cut it, get them out and it goes smooth, its more likely to have theese simptoms reduced. but also organisms responds different at surgery. Anyway its normal.

  3. Lisa Terpin permalink

    I had a prc done on Tuesday and am currently splinted with pressure dressing. The wrist hurts especially if i inadvertently use it but my concern is my fingers. Three of them look discolored up to the top knuckle….nailbeds are pink as is my palm. Is this bruising?

    • Have you reviewed my pictures from day one to 14?

      • mary brightman permalink

        i haven’t seen your pictures, but i know my fingers looked like purple sausages for weeks and weeks. i’m 3 mos post and still have sweeling in my fingers, feels terriblly uncomfortable. always feel like my hand is swollen have new and strange lumps on palm of hand and now a larger lump at the base of thumb on palm side. its been really hard and long so far. i wonder if it was worth it.

  4. Hello. Got a question for thoose who had PRC. Its 8th day after, doral side looks fine.
    But I m worried about my palmar side wich at first day post op had been like a bag of blood in my wrist.
    Maybe it s because of my condition before surgery, athrophied for 2 months before and my 1/2 scafoid and dislocated lunate were pushing in my flexor tendons, maybe the place it s irritated from pulling them out.
    Anyways the bag of blood it s halfway gone, it’s normal? how much time it takes for the wrist to be cleaned up?

  5. Don marius permalink

    Im 26. Skater as basic profession. Or wuz. Ive hâd whole proximal row fucked up from a scaphoid NON unison FOR 4 yrs before. Prc was my only option. Im also in kinetoterapy as student and did a lot of gymnastics A-T bar.
    1. Search Nice surgeon
    2. Change LifeStyle
    3.nutrition, sleep, meditațion
    4. ICE and meds and showers
    ….whatever u can do

    Remember surprins cant Tell ur future and anatomy is changed u have to work a lot with it in Maters of years. Also dependent on ur capotat radius condition. If u old or young, snooker, drinker. Im 3rd day post surgery and it was painfull Buț im optimitisc. My adviceis to change the powerfully LifeStyle and focus also on the rest of ir body. Ive changed in my strength usage inequally long before surgery. I will personalul improve cardio and quit skating A-T least One year. Ill Keep posting

  6. I didn’t think this blog was being updated so nice to see people replying still. I had PRC the end of October (2017) and have no vertical wrist movement (about 6 degrees extension, no flexion). My finger movement although a little stiff is very good but the rest is making me depressed. The minimal pain I experienced with a failed bone graft or the pain before the failed graft were so insignificant in comparison. My physio appointments are pure torture. I’ve just been prescribed pregabalin and co-codymol to help with the pain. This blog has at least given me some hope though, I just need to remember that if I left the arthritis inducing injuries that too could have been terrible.

    • steve schlanger sr permalink

      Hey James,
      I had bi-lateral PRC in January of ’17. Bottom line for me; if I stay away from strenuous physical activity (hammer, sawsall, chainsaw, etc.), I am relatively pain free. Limited movement and loss of grip strength are the price paid for relief. Given that I am retired, it is within reason to limit activity. Perhaps my single biggest disappointment has been that I can no longer pursue one of my hobbies; bass fishing, just can’t seem to hit the target and it becomes very uncomfortable in a very short time. As I have said here before, progress is measured in micro mm. Would I do it again? Good question. Like you, if I could somehow know the alternative outcome???????, but that is not possible. I will take not having to sleep with my forearms vertical and the pain free part, be happy I had good insurance, and do more of hobby #2: Bar-B-Que. Hang in there, it does get better!

  7. Corey pitman permalink

    Update.. 7 days after surgery and pain meds are hardly needed. Have feeling in fingertips and swelling has gone down tremendously. But from the knuckles on the hand and above not much feeling at all. Able to touch thumb to forefinger, middle and ring finger. All throughout the day I move fingers with arm in various positions. Splint and stitches will be removed on Oct 30th. Then cast on wrist/hand. I’ll update again later..

    • Corey pitman permalink

      Its been a month and a week since surgery. I spoke too soon in my last update. After 9th-11th day post op pain was unbearable. After the cast came off had to immediately put on a brace for the pain without support had me in tears. Can’t make a fist whatsoever. Physical therapy is pure torture. Almost regret having this surgery. Its been a very miserable, slow and horrendous recovery.

    • Corey pitman permalink

      Its been a month and a week since surgery. I spoke too soon in my last update. After 9th-11th day post op pain was unbearable. After the cast came off had to immediately put on a brace for the pain without support had me in tears. Can’t make a fist whatsoever. Physical therapy is pure torture. Almost regret having this surgery. Its been a very miserable, slow and horrendous recovery.

      One other thing, middle and ring finger knuckles on the hand to half way down the back of the hand is still numb and feels like an I’ve pick is being shoved between the two knuckles. Almost feels like when you’re getting back feeling after frostbite.

      • steve schlanger sr permalink

        I too have used the “ice pick” analogy to describe the pain felt when dealing with the results of PRC. It does get better with time but it was a slow process in my case. I sometimes think to myself that perhaps I made the MoAM (Mother of All Mistakes), but then I remember why I chose to do it in the first place. Do your best to be patient and focus on any improvements no matter how small. Regarding PT, YOU determine how far to push it: period!
        Wish you the best possible recovery and hope to read of your continued improvement in the very near future.

  8. Debbie permalink

    Reply was for Corey – sorry new at this.

  9. Corey pitman permalink

    I am having the PRC Oct 18, 2017. I’ve been reading bad outcomes of the procedure but have also seen many videos of people who have had the procedure that seem very happy with the results. I’ve had a broken scaphoid bone for more than ten years now and somehow have a new break. Personally, I’m ready for the surgery for I’m tired of the pain.I’ll try to post results.

    • steve schlanger sr permalink

      10-14-17
      Hey Corey,
      I had bi-lateral PRC in February of this year. The first week is pretty tough, but you get through it. FYI: if you are the kind of person that uses saws, swings hammers, and generally is hard on your body, don’t expect a miracle. The original pain is gone, but, nothing comes free of charge. You cannot ask enough questions ahead of the surgery, period. The only daylight my bass boat sees is when I open the garage door to get the car out. Trying to throw a lure feels like I’m driving a nail in the end of my arm. Just my personal experience so far.

      • Corey pitman permalink

        Day 5 after surgery and pain is there but bearable. Have feeling in all fingers and throughout the day I make sure to move them as much as possible. I was told if I dont they may lock in place as healing progresses. But hand still swollen and very numb. Follow up with Dr is on the 30th to remove stitches and put on a cast. 3-4 wks of the cast then physical therapy. I’ll come back from time to time to update.

      • Corey pitman permalink

        Geez, I’m a mechanic by trade and your info kinda scares me, Steve. But I’ve dealt with the pain thus far and Dr did remove a nerve as well. I’m not expecting a miracle just praying the general pain is gone in the end. Hoping you dont have to sell the boat. That would be like giving in… Thanks for taking time for your insight…

    • Debbie permalink

      Thinking about you and your results. Too soon to type I’m sure. I’m so nervous about having mine. I am reading so many mixed results. Yours is recent so maybe the surgery has had some improvement. I’m saving this blog to look in the future.

      • Corey pitman permalink

        Thank you. Procedure was done on my dominant wrist/hand so EVERYTHING from now on is done with the other. Its like a two year old learning everything. I’ll try to post results from time to time. I gave an update in response to my original post above.

  10. Hilary permalink

    I had PRC in October of 2013 for stage 4 kienbocks disease. Last wekend i tripped over some logs on the ground and fell and landed on this wrist to catch my fall. It swelled up immediately and is still swollen and bruised. I have some movement and flexibiliity but not as much as I had before the fall. does anyone know anything about injuries to the wrist post PRC?

    • Cathy permalink

      Ice ice and more ice plus antiinflamtotis

      • Corey pitman permalink

        Ice always caused me more pain. As well as the cold weather.

    • mary brightman permalink

      falling on it is my biggest fear. glad you didn’t cause more damage.

  11. Elizabeth permalink

    My sister has had a right wrist prc and is now 2days post op. Today and yesterday she has had some bleeding through her compression bandages. Can anyone else relate to this or is it worth getting it reviewed. The day she was released from hospital a member of staff (not physiotherapist or consultant) was bending her fingers upwards and trying to get her to hold them there. So we are unsure if this could have caused the bleeding

    • Cathy permalink

      I had mine done 2 years ago and did not have any bleeding. I’m not sure why they would have tried bending fingers.

  12. Joshuwa permalink

    I have done prc few weeks ago so now um going to a therapist , and i am a person who lift heavy waits its and can i get my total strengh back??

    • Not certain what the total recovery will be.

    • steve schlanger sr permalink

      Joshuwa,
      I am five months out from surgery and my best guess is that I am at about 50% of the strength I had prior to the procedure.

  13. LISA permalink

    Hi, just joined this blog as my procedure was May 2. Having to manage pain with NUCYNTA…allergic to Percocet. Hate taking any pain meds. Hard to sleep and little appetite.
    Any suggestions on dietary recommendations to enhance healing and Best way to position arm while sitting up during the day and while sleeping at night? My arm is bandaged in an Ace bandage and a splint from elbow to palm. Thanks.

    • steve schlanger sr permalink

      Had the procedure, bi-lateral, two months ago. My suggestions would be:
      -keep it elevated as much as possible
      -sleep with the forearm resting vertically on a pillow, above the level of the heart
      -do not hesitate to use ice
      Progress is measured in fractions of units, but it does get better, slowly.

  14. steve schlanger sr permalink

    4-20-17
    Eight weeks out from PRC on both wrists (at the same time). No reservations regarding both wrists at the same time. I have never encountered such pain as that which I endured upon waking up and the following two weeks. Eight weeks later, I am not able to squeeze a caulking gun, hold a 4″ side grinder, or carry in excess of 3-4 lbs. in one hand. ROM, beyond “static” is painful and very limited. To anyone considering PRC; you cannot possibly ask enough questions in advance of surgery.

  15. shawn permalink

    if i cant bend my wrist after proximal row carpectomy what do i do

    • Cathy permalink

      I am 16 months post surgery and have very little movement. Be careful not to push that movement too much. Remember the surgery removes some if not all bones in the proximal row. Movement probably depends on how many are removed. In my case they removed three.

  16. Carri W permalink

    Two months ago had PRC and am battling swollen fingers. Doc said I did not move fingers enough and ligaments shrunk. Many excruciating PT sessions trying to stretch and still swollen. My hand is like a claw. I can keyboard and do many things but I have many limitations. The wrist does not hurt and I’ve been doing rigorous exercises along with contrast baths numerous times a day, all in the hope of stretching finger ligaments. I followed instructions from the beginning but I didn’t expect this situation. Hand therapist said if we can’t get swelling down to stretch ligaments, at some point they may never stretch. Has any one had this problem? I moved fingers after surgery but not vigorously enough, obviously. Did everyone’s doc tell them to keep the fingers moving after surgery?

    We’re you warned that if you don’t move fingers ligiments could shrink?

    Wrist actually feels good and have not had much pain. Hand and fingers are super stiff in the morning. I wake up and start moving my fingers.

    Note: anyone getting ready for the PRC, ask your doc about this situation to find out how much to move fingers. I have never given birth but these PT sessions to stretch ligiments are the most painful thing I have ever experienced. BEWARE

    • I had this. If you read through the days after surgery and my constant complaint about fingers you will see. The good news, its finally gone after a few years. However, they often will get stiff in the morning if you lift too much or drink too much.

      Years later I would say I am doing fine, no complaints and I do not even notice it in my every day life.

      • Fatima permalink

        Hi! My name is Fatima. I am 4 weeks post PRC. Just wanted to thank you for such an informational blog. I am looking forward to having my cast removed next week. I can move m th fingers and have no swelling however I feel no strength in my hand. How long did it take you before you could feel strength in the hand/wrist?

      • I think every case is different.

    • Linda Bona permalink

      yes I even had a printed copy of finger exercises to do each day . My fingers were and are as normal as my other hand.

  17. Ron permalink

    I am planning to have a PRC done in the near future. If there are not complication, can anyone give me an indication of recovery time to resume recreational activities like golfing and yoga ?

  18. Cathy permalink

    Hi Linda, I just had the PRC done about 8 weeks ago. It has not been bad just a little uncomfortable. I still don’t have much range of motion but that will take time. Go out and buy the ice packs…I bought 3 or 4 so I always had one available. My scar is barely visable and I am starting to use right hand again to type and drink coffee. If you do have to have the surgery and have any questions please don’t hesitate to email me.

    This is a wonderful site for information:0)

  19. Hi Peter, This site is so informative. I may have to have the PRC surgery done soon. Am going to another surgeon for a second opinion and all of the comments are so helpful in explaining everything that people have gone through (pre-operative & post-operatively). I have been trying to print the comments so I could re-read them before I make a decision on whether or not to have the surgery now, but I can’t print anything from this site……….is there a reason for that?

  20. How long can I expect to be out of work once I have the PRC surgery?

    • I can not send this to the surgeon because the length of time out of work depends on too many variables such as type of work, injury, surgery etc… My surgeon would not answer this. I was out for about 1-month.

  21. Hi Peter thank you so very much for this blog. I had PRC done on my dominant hand last year and I also had a lot of swelling and my fingers also get very painful and stiff in the AM and using the computer. had my 72 days check up with my Dr. and found out that my surgeon would have to go back in to take a peace of the bone off below my thumb, because there is still some swelling and pain when I try to bend my wrist inwards. did u have this done. I am just worried about doing this and the prolong recovery time and I am also interested in the diet you followed. It is very frustrating not knowing if or when I would be able to return to work as I am a Health Care Provider.

  22. Hi Peter

    Your blog is so useful, thank you very much. I have just had Joint leveling of my right wrist with a possible PRC in the future. My right radius bone was shortened by removing a section of the bone. This leveling procedure reduces the forces that compress the lunate and often stops the progression of the disease. I am very interested in your diet but unfortunately I live in New Zealand and do not have access to many of the products that you have recommended. I am also a motorcyclist and have not been able to ride motorbike now for 6 months. Very frustrating and I don’t see myself being able to ride for another year.

  23. Thank you so much! I am going to take your advice. Today, I noticed less swelling and more pain, pain from stitches, pain in the ulnar side of my wrist and pain on the underside as well. i’m hoping that I can get some sleep soon, as I’m running on empty. Thank you for this blog, and for the insight into what may possibly be a very regrettable decision.

  24. Hi, I just had PRC on Tues Nov. 11, and my first two days were great. The 3rd day until now, I’m so swollen I can’t do my exercises, and I don’t get my stitches out until Thursday Nov. 20th. I have a great surgeon, and caring hand therapy staff, but I am really having a rough time with the swelling. My hand looks like elephant-man’s hand might look. It is 3 times the size it should be. Did anyone experience this after surgery? I do have Mixed Connective Tissue Disease and Lupus so maybe it is just because of my underlying diseases, but I’m in a lot of pain and the pressure of the edema is really uncomfortable. Any suggestions besides holding my hand in the air above my head, wiggling my fingers, and praying that I will be able to sleep?

    • Hi,

      I have found that diet is very important to reducing swelling and inflammation. I especially have had success drinking 8-10 full glasses of water daily, having a double shot of wheat grass and also I use Wobenzyme (http://www.wobenzym.ca/) that helps after a surgery to reduce inflammation. I too had an not so successful PRC and I was swollen quite a bit if you look at some of the pictures in my early days after the procedure. One year after I still get a bit swollen in my fingers if I relax my diet or drink wine.

      • mary brightman permalink

        Peter where may i find the pictures please.

  25. Cathy permalink

    Hi all fellow PRC candidates and graduates,
    I am scheduled for one this Dec 2014…I am confused and frightened. For those of you who have gone through this what would be your suggestion as far as taking short term disability? I am a software developer like Peter and depend very much on my right dominant hand. Would you suggest 2 weeks? Here is the kicker…if they get in there and find that a PRC may not work then they will fuse it right then and there…yea…how nice! So do I prepare for 2 weeks or 4 weeks if they do a fusion.

    What a great site you have created for us who have this prognosis. I thank you very much Peter.

  26. 6 months ago I fractured my scaphoid. From my very recent MRI “Comminuted fracture of the mid to distal pole of the scaphoid, with subcortical cysts and marrow edema surrounding the fracture line and mild volar subluxation of the distal fracture fragment. There is an additional non-displaced fracture of the proximal pole. Mild to moderate dorsal rotation of the lunate. Moderate to severe osteoarthritis of the scaphoid/trapezium/trapezoid joint.” So my right scaphoid is trashed and hasn’t healed at all and is losing it’s blood supply. I have 3 options, PRC with scaphoid excision, 4 corner fusion with scaphoid excision, or full wrist fusion. The latter is not an option since I use my hands for jewelry making and play guitar. I’m concerned about the healing time with the PRC. My doctor said since there are no bones to heal, the healing time is faster but it takes time to relearn how to use your hand again. I live alone and I know how difficult it is to be in a cast when it’s your dominant arm. I also don’t need the down time. I could wait it out but the Dr. says he can’t guarantee that my surgical options would be the same.

    • If the doctor suggests that you have it, you should in my opinion. If the PRC goes well (33% of the time) healing is quick.

    • Patricia permalink

      Ann, I am having PRC done this morning. I too live along and I understand the struggles that come with having to do everything for yourself. How are you doing now, and do you most of your wrist functions still?

      • mary brightman permalink

        Patricia and Ann, i live alone, with my 4 dogs. and had my PRC done. i tried to plan ahead, paperplates, plastic utensils. so as not to do dishes. i actually went out and bought a freezer and filled it with great food from Costco that i could microwave or put in my large toaster oven. i bought huge sweatshirts and shirts with big wide arms to allow me clothing to wear. sweatpants. because pulling up anything but loose sweatpants was impossible. i bought one of those can openers that you put it on the can push the button and it rotates around the can. i got a bagel slicer. these things helped a lot. but still so many things are so hard or impossible like opening a jar, poptop cans. and be very careful if you have your microwave above counter. that is dangerous. may be good to invest in a cheap countertop one. i still can’t after 3 mos. lift much more than cell phone, can’t turn door handles with that wrist. driving kills me. i have to wear the brace for that and even with it, by the time i arrive home from a few errands, i need a pain killer. showers. well thats a joke. i wrapped small trash can liners around mine with large elastics to keep closed. i even went so far as to cut my hair shorter because you can’t use any styling equipment, if i can help with anything, pls ask. i didn’t think i would make it thru, but i did.

  27. Does Dr. McCabe severed the terminal branch of the posterior interosseous nerve in the operation he did on you? Thank you

  28. Martha permalink

    There is strange popping sensation in wrist with prc surgery due to keinboch disease . Any idea why this is happening. No pain

  29. Rod permalink

    I am having a PRC December 3rd. While I have many questions, my main questin is related to the wrist/forearm relationship after the row of bones are removed. How is the wrist attached to the forearm when you remove the bones that are attached to the forearm?

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