Total Wrist Denervation: Survival Study and Functional Outcomes

Study Overview
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Brief Summary
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The purpose of the study is to evaluate the long-term effectiveness of total wrist denervation on pain by assessing the surgery survival. The residual functional wrist's quality and the patients' satisfaction will also be evaluate.

Detailed Description
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The degenerative diseases of the wrist are numerous and include both post-traumatic osteoarthritis lesions and inflammatory diseases. In any case, one of the main reasons for consultation is pain. In case of inefficiency of a well-conducted medical treatment (splints, anti-inflammatories, infiltrations), surgical management remains difficult because of the multitude of treatments that can be offered: partial or total arthrodesis of the wrist, prosthetic arthroplasties, pyrocarbon implants or proximal row carpectomy. But these treatments are heavy and can potentially be sources of complications such as stiffness, loss of strength or progressive wear of the implant. Total wrist denervation is an alternative since 1966. The original technique follows an anatomical study of the innervation of the upper limb. This technique has been proven to significantly improve pain without major after effects. Several teams demonstrated a decrease in pain associated with conserved strength and mobility, but few studies have studied the long-term results of this technique, especially on the absence of residual pain. The purpose of this study is to evaluate the long-term effectiveness of denervation on pain by assessing the surgery survival, the residual functional wrist's quality and the patients' satisfaction.

Official Title
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Total Wrist Denervation: Survival Study and Functional Outcomes

Conditions
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Wrist Arthritis, Survival

Intervention / Treatment
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* Procedure: Total wrist denervation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient undergoing total wrist denervation between January 1995 and December 2013 at Brest CHRU, performed by the same senior surgeon Exclusion Criteria: patient who had another intervention at the same time (confounding factor) refusal expressed by the patient to participate in the study
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Population of the study<br>Patient undergoing total wrist denervation between January 1995 and December 2013 at Brest CHRU, performed by the same senior surgeon. Total wrist denervation is a routine procedure in orthopedic surgery for wrist arthritis. | Procedure: Total wrist denervation<br>* Study of the files<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| survival over time | duration (in years) of absence of surgical revision, and residual pain < or = 3 on a pain numerical scale (0 to 10, WHO criteria for mild pain) | from date of surgery until the date of first documented failure (surgical revision; pain > 3), assessed up to the inclusion date | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| surgery survival over time | duration (in years) of absence of surgical revision | from date of surgery until the date of documented failure (surgical revision), assessed up to the inclusion date | 
| residual pain | numeric pain rating scale (between 0 to 10; 0 equal no pain; 10 equal worst pain imaginable) | at the inclusion date | 
| residual functional wrist's quality | Result of the DASH (Disabilities of the Arm and Shoulder Disabilities) score (between 0 to 100; 0 equal better result; 100 equal worst result) | at the inclusion date | 
| patients' satisfaction (1) | analogue scale between 0 to 10 at the last follow-up (0 equal minimum; 10 equal maximum) | at the inclusion date | 
| patients' satsfaction (2) | answer to would you repeat this procedure again? | at the inclusion date | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Long-term result, Denervation