Functional outcomes and quality of life in patients with proximal row carpectomy
Nuray Akkaya1, Fahir Demirkan2, Semih Akkaya2, Oğuzhan Gökalp2, Çağdaş Yörükoğlu2, Füsun Şahin1
1Pamukkale Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Denizli, Türkiye
2Pamukkale Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Denizli, Türkiye
Keywords: Functional status; proximal row carpectomy; quality of life; rehabilitation.
Abstract
Objectives: This study aims to assess pain, functional status, patient satisfaction, and quality of life in patients with proximal row carpectomy.
Patients and methods: Between December 2007 and November 2011, demographic, clinical, and operational data, and physical therapy program of 16 patients (11 males, 5 females; mean age 41.4±16.6 years; range 19 to 77 years) with proximal row carpectomy were recorded. Pain (0-no pain, 10-severe pain), and patient satisfaction (0-not satisfied, 10-very satisfied) were assessed with visual analog scale (VAS). Wrist range of motion, and hand grip strength were evaluated. The quick-disabilities of the arm, shoulder and hand (Q-DASH), and Mayo wrist score were used for functional evaluation of the upper limb. Short form-36 (SF-36) was used for the evaluation of quality of life.
Results: Postsurgical duration was 20.6±16.4 (range; 6-56) months. Complex regional pain syndrome (CRPS) was detected in two patients (%12.5). The mean session numbers of physical therapy were 16.7±9.4 (range; 0-30), satisfaction VAS was 8.4±2.1, rest VAS 0.8±0.9, activity VAS was 2.3±2.2, grip strength of operated side 82% of nonoperated side, Q-DASH score was 13.4±16.5 (substantially good), and Mayo wrist score was 80.0±19.4 (good). Significant improvement was detected in postoperative flexion-extension arc compared to preoperative status (p=0.001). A correlation was detected between hand grip strength percentage and session numbers of physical therapy (p=0.025, r=0.558). Relationships between quality of life-pain subscore and activity pain (p=0.001, r= -0.819), Q-DASH (p=0.003, r= -0.698), and Mayo wrist score (p=0.037, r=0.525) were detected. The presence of complication was the only independent variable for prediction of functional status in multivariate linear regression analysis.
Conclusion: Increased number of physical therapy session results in improved hand grip strength following the proximal row carpectomy, while CRPS complication which can be seen after surgery affects the functional status adversely.