La dénervation totale du poignet : une étude rétrospective de 27 cas au recul moyen de 77 mois

Simon, É.; Zemirline, A.; Richou, J.; Hu, W.; Nen, D. Le

doi:10.1016/j.main.2012.07.005

Cited by 22 publications

(6 citation statements)

References 22 publications

(21 reference statements)

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“…Based on the literature, it seems that better results can be obtained for SLAC lesions, distal radius fracture sequelae [12,13] or Kienbö ck disease [19] in terms of grip strength, range of motion, and pain relief. However, like Simon et al [17], we could not find any differences in outcomes by the indications in our study. Our study confirmed previous studies showing 75% reduction in pain.…”

Section: Discussionsupporting

confidence: 65%

“…Example of a patient with stage 1 SLAC preoperatively (A) and stage 2 at 3 years after wrist denervation (B). cases [14,17], with recurrence of pain in some cases [11,13]. Based on the literature, it seems that better results can be obtained for SLAC lesions, distal radius fracture sequelae [12,13] or Kienbö ck disease [19] in terms of grip strength, range of motion, and pain relief.…”

Section: Discussionmentioning

confidence: 99%

“…Braga Silva et al [14] reviewed 49 patients treated with Wilhelm's technique and found neuromas associated with the radial dorsal digital nerve of the index finger; most patients reported transient hypoesthesia in the territory of the superficial branch of the radial nerve. Simon et al [17], using a three incision procedure, reported 4 cases of transient hypoesthesia in the territory of the superficial branch of the radial nerve out of 29 patients. One required a revision procedure with resection of the neuroma.…”

Section: Discussionmentioning

confidence: 99%

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Denervation of the wrist with two surgical incisions. Is it effective? A review of 33 patients with an average of 41 months’ follow-up

Delclaux¹,

Elia²,

Bouvet³

et al. 2017

Hand Surgery and Rehabilitation

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Denervation of the wrist with two surgical incisions. Is it effective? A review of 33 patients with an average of 41 months’ follow-up

Delclaux¹,

Elia²,

Bouvet³

et al. 2017

Hand Surgery and Rehabilitation

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“…The level of pain reduction after denervation of the wrist varies. Studies describe painlessness after wrist denervation between 12%–44% with a range of follow-up times between 4.2–9.6 years (Ferreres et al., 1995; Fuchsberger et al., 2018; Grechenig et al., 1998; Hohendorff et al., 2012; Ishida et al., 1993; Radu et al., 2010; Rothe et al., 2006; Schweizer et al., 2006; Simon et al., 2012; Wilhelm, 2001).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of proprioception in denervated and healthy wrist joints

Rein

Winter

Kremer

et al. 2020

J Hand Surg Eur Vol

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We recruited 25 patients after complete wrist denervation and 60 healthy adults to investigate conscious and unconscious proprioception of the wrist. Ipsi- and contralateral joint-position sense, force sense, and wrist reflexes were measured. The latter were triggered by a trapdoor, recording electromyographic signals from the extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris muscles. No significant differences were found for joint position sense, force sense, and wrist reflexes between both groups, except for reflex time of the flexor carpi ulnaris after denervation of the left wrist as compared with the left flexor carpi ulnaris in controls or in right operated wrists. At a mean follow-up of 32 months (range 8 to 133), we found no proprioceptive deficit of the conscious proprioceptive qualities of joint position sense, force sense, and the unconscious proprioceptive neuromuscular control of wrist reflex time for most muscles after complete wrist denervation. We conclude from this study that complete wrist denervation does not affect the proprioceptive senses of joint position, force sense, and reflex time of the wrist.

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“…While there is yet to be a consensus on the appropriate technique and nervous targets for an isolated denervation, total wrist denervation has been shown to offer better longterm outcomes for pain relief. 9 The presence of persistent ulnar wrist pain for partial wrist denervation, 10 neuromas and decreased grip strength for complete wrist denervation are known complications, 11 although there still is a lack of research on the significance of these effects. Additionally, coding for the procedure has variability without a consensus.…”

mentioning

confidence: 99%

Use of Wrist Denervation in the Treatment of SLAC and SNAC Wrist by ASSH Members

2022

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Background Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) are common patterns of wrist arthritis, and surgical treatment options include partial and total wrist arthrodesis and wrist denervation, which maintains the current anatomy while relieving pain. Introduction The purpose of this study is to elucidate current practices within the hand surgery community with respect to the use of anterior interosseous nerve/posterior interosseous nerve (AIN/PIN) denervation in the treatment of SLAC and SNAC wrists. Methods An anonymous survey was distributed to 3,915 orthopaedic surgeons via the American Society for Surgery of the Hand (ASSH) listserv. The survey collected information on conservative and operative management, indications, complications, diagnostic block, and coding of wrist denervation. Results In total, 298 answered the survey. 46.3% (N = 138) of the respondents used denervation of AIN/PIN for every SNAC stage, and 47.7% (N = 142) of the respondents used denervation of AIN/PIN for every SLAC wrist stage. AIN and PIN combined denervation was the most common standalone procedure (N = 185, 62.1%). Surgeons were more likely to offer the procedure (N = 133, 55.4%) if motion preservation had to be maximized (N = 154, 64.4%). The majority of surgeons did not consider loss of proprioception (N = 224, 84.2%) or diminished protective reflex (N = 246, 92.1%) to be significant complications. 33.5%, 90 respondents reported never performing a diagnostic block prior to denervation. Conclusion Both SLAC and SNAC patterns of wrist arthritis can result in debilitating wrist pain . There is a wide range of treatment for different stages of disease. Further investigation is required to identify ideal candidates and evaluate long-term outcomes.

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La dénervation totale du poignet : une étude rétrospective de 27 cas au recul moyen de 77 mois

Cited by 22 publications

References 22 publications

Denervation of the wrist with two surgical incisions. Is it effective? A review of 33 patients with an average of 41 months’ follow-up

Denervation of the wrist with two surgical incisions. Is it effective? A review of 33 patients with an average of 41 months’ follow-up

Evaluation of proprioception in denervated and healthy wrist joints

Use of Wrist Denervation in the Treatment of SLAC and SNAC Wrist by ASSH Members

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