Arthroscopic Proximal Row Carpectomy Using the Volar Central Portal

Abstract

Proximal row carpectomy (PRC) is a well-accepted procedure for the treatment of degenerative lesions of the wrist and advance Kienböck disease. This procedure has been classically described as an open procedure but recently has been reported as an arthroscopic one. Arthroscopic PRC has several advantages such as minimal damage to the dorsal and volar ligaments as well as there being no need to detach the capsule, which can facilitate earlier mobilization and can decrease postoperative stiffness. In addition, there is a reduced risk of the interosseous posterior nerve being injured, and the proprioception system continues to function.This arthroscopically assisted technique uses the volar central portal as a third portal, which can be useful to remove the volar portions of the bones to view the dorsal areas of the bones and to allow the surgeon to work with 2 instruments at the same time. As a result, the time spent on the procedure can be reduced.