Proximal Row Carpectomy Darrach Allograft Arthroplasty
This case demonstrates severe radio-carpal joint and distal radio-ulnar joint arthrosis. If the lunate fossa of the radius is preserved a proximal row carpectomy can be performed allowing the capitate to articulate with the distal radius in the lunate fossa. If the lunate fossa and/or proximal capitate is involved and shows degenerative arthritic changes an interposition arthroplasty is required. The distal radio-ulnar joint arthitis is treated by resection of the distal end of the ulna (Darrach Procedure).
Fascia lata allograft is folded on itself and sutured to maintain the desired shape that will occupy the void created by the proximal row carpectomy.
Post-operative radiograph showing the distal ulnar resection and the absence of the proximal carpal row and the interval maintained by the graft. This procedure eliminated the arthritic pain since the arthritic bones are no longer able to grind upon eachother.