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      Partial wrist denervation versus total wrist denervation: A systematic review of the literature.

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          Abstract

          The aim of this systematic review was to understand which procedure-total or partial wrist denervation-provides better results in terms of pain relief and function. This review was registered on PROSPERO (CRD42018088856). We searched the Medline (PubMed), Web of Science and Scopus databases. Twenty-one studies were included in this review. We assessed the quality of the studies using the Coleman Methodological Score. Data on demographics, surgical indications, diagnostic methods, follow-up periods, type and rates of complications, survivorship of the procedure, return to work, and outcome measures were recorded. A total of 1065 patients were included in this review; the mean quality of the studies included was considered poor. The outcomes could not be analyzed because none of the studies had reliable outcome data reported, but both procedures were effective in terms of pain relief and range of motion. Partial wrist denervation has an average subsequent procedure rate of 19%. Total wrist denervation had an average subsequent procedure rate of 4.7%. No complications were reported in any patient who underwent partial wrist denervation versus 20 patients who underwent total wrist denervation. Both partial and total wrist denervation are safe and reliable procedures that can provide good pain relief and preserve wrist range of motion. Total wrist denervation offers better long-term outcomes in term of pain relief, with fewer subsequent procedures being needed compared to partial denervation, and with a low complication rate. LEVEL OF EVIDENCE: Level III, Systematic review, Therapeutic.

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          Author and article information

          Journal
          Hand Surg Rehabil
          Hand surgery & rehabilitation
          Elsevier BV
          2468-1210
          2468-1210
          December 2020
          : 39
          : 6
          Affiliations
          [1 ] Department of Orthopedic Surgery, "Federico II" University, Via S. Pansini 5, bd. 12, 80131 Napoli, Italy. Electronic address: francesco.smeraglia@gmail.com.
          [2 ] Department of Orthopedic Surgery, "Federico II" University, Via S. Pansini 5, bd. 12, 80131 Napoli, Italy.
          [3 ] Chelsea and Westminster NHS Trust, 369, Fulham road, SW10 9NH London, United Kingdom.
          Article
          S2468-1229(20)30126-2
          10.1016/j.hansur.2020.05.010
          32659384
          71d2186c-21a5-405b-a4e6-23951bfa4514
          History

          Dénervation,Arthritis,Arthrose,Denervation,Poignet,Wrist
          Dénervation, Arthritis, Arthrose, Denervation, Poignet, Wrist

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