Wrist denervation yielded improved pain scores long term

Braga-Silva J. J Hand Surg. 2011;36:961-966.

Six-year results showed that wrist denervation yielded pain score improvements in 39 patients despite radiological deterioration in some patients over time, according to these retrospective study results.

Jefferson Braga-Silva, MD, PhD, Hospital São Lucas da Pontifical Catholic University of Rio Grande do Sul, and colleagues conducted a retrospective study of 49 Wilhelm’s wrist denervations. The surgeons performed the denervations as isolated procedures in patients with painful wrist conditions. This surgery was indicated for wrist degenerative osteoarthritis caused by scaphoid nonunion advanced collapse (19 patients), Kienböck’s disease (13 patients) and primary degenerative osteoarthritis (17 patients).

The researchers analyzed the results as a group and compared the three etiologies. For all groups, average pain improvement postoperatively was 68% after the first month. It reached a plateau at the end of the first year and remained stable at 36 months.

“Grip strength on the treated side improved from 43% of the opposite side before denervation to 69% of the opposite side,” the authors wrote.

In all axes of movement, the range of motion demonstrated improvements, without statistical differences between groups. After 72 months, radiological evaluation showed worsening in 34 patients. The three groups demonstrated no differences with regard to grip strength, range of motion or pain relief.