Partial Wrist Denervation for Idiopathic Dorsal Wrist Pain in an Active Duty Military Population.

ABSTRACT

PURPOSE: Treating dorsal wrist pain of unknown etiology provides a challenge to the most experienced hand surgeon. Therefore, we conducted a study aimed to determine outcomes of patients undergoing a posterior interosseous nerve (PIN) or anterior/posterior interosseous nerve (AIN/PIN) neurectomy for wrist pain without a known cause, in patients who responded to preoperative injection. METHODS: A retrospective chart review was performed of all active duty patients undergoing isolated PIN or AIN/PIN neurectomy for idiopathic dorsal wrist pain with a documented response to preoperative injection between December 2011 and April 2017. Demographic data, return to duty status, pain scores, and range of motion were among the data collected and reviewed. RESULTS: The initial search yielded 108 patients of whom 13 met inclusion criteria for our study. Overall, only 2 of 13 patients were able to return to full duty without restrictions, 5 went on to medical discharge, and 6 were placed on permanent duty restrictions. No patients within our study were deployed. Patients had improvement in their pain scores from 4.0 to 2.2. Range of motion was similar before and after surgery. CONCLUSIONS: A PIN or AIN/PIN neurectomy resulted in improvement in pain scores in patients, but was not successful in returning the majority of patient to full active duty status without restrictions. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.