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Proximal row carpectomy is a motion-preserving wrist surgery that removes the scaphoid, lunate, and triquetrum. These three bones form the proximal row of the carpus. After removal, the capitate articulates directly with the lunate fossa of the radius to create a new functional wrist articulation. The procedure reduces pain while preserving more wrist motion than a total wrist fusion.
read more about proximal row carpectomy ...The procedure is used for selected patterns of wrist arthritis and carpal collapse, including scapholunate advanced collapse and scaphoid nonunion advanced collapse. It can also be used after certain severe carpal injuries when the remaining joint surfaces are suitable. The cartilage on the capitate head and the lunate fossa of the radius must be adequate for the new articulation to function well. Advanced damage at these surfaces can make another salvage procedure more appropriate.
The surgeon reaches the carpal bones through a wrist incision and removes the scaphoid, lunate, and triquetrum while protecting nearby tendons, nerves, and ligaments. The capitate is then allowed to settle into the space formerly occupied by the proximal carpal row. Surgeons inspect the capitate head and radial cartilage to confirm that the new articulation is suitable. Additional procedures can be performed when needed to address impingement, instability, or associated wrist pathology.
The wrist is commonly immobilized for a period after surgery while swelling and soft tissues heal. Hand therapy then works on gradual motion, grip strength, scar mobility, and return to functional activities. Patients generally retain useful wrist motion, although strength and range of motion do not return to normal. Heavy manual work can remain difficult, and long-term results vary according to age, activity demands, and cartilage condition.
Possible complications include infection, stiffness, persistent pain, weakness, nerve irritation, and loss of wrist motion. Degenerative changes can develop over time at the new capitate-radius articulation. Some patients have persistent symptoms or progressive arthritis and later require total wrist fusion or another salvage operation. Outcomes can be less favorable in people whose work places heavy repetitive loads on the wrist.
The scaphoid, lunate, and triquetrum are removed. These bones make up the proximal row of the wrist.
No. It is designed to preserve wrist motion by creating a new articulation between the capitate and radius.
Arthritic change can progress at the new joint surface over time. Some patients later need another salvage procedure if pain becomes severe.
Usually not. Many patients regain useful function, but grip strength and motion commonly remain lower than in an unaffected wrist.
Arthritis of the Wrist. OrthoInfo, American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-wrist/. Date Accessed August 12, 2026.
Proximal Row Carpectomy in Young Patients. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC8189603/. Date Accessed August 12, 2026.
Long-Term Outcomes of Proximal Row Carpectomy: A Systematic Review of the Literature. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC3658690/. Date Accessed August 12, 2026.
Proximal row carpectomy vs four corner fusion for scapholunate (SLAC) or scaphoid nonunion advanced collapse (SNAC) wrists: a systematic review of outcomes. PubMed. https://pubmed.ncbi.nlm.nih.gov/19369301/. Date Accessed August 12, 2026.
Routinely-Collected Outcomes of Proximal Row Carpectomy. PubMed. https://pubmed.ncbi.nlm.nih.gov/36372595/. Date Accessed August 12, 2026.