Journal of Hand Surgery - June 2022 - S260

S260
Journal of Hand Surgery (Eur) 47(Supplement 1)
Conclusions: Given the still debated advantage of a
vascularized nerve graft versus a non-vascularized
one, constant anatomy showed that this flap could
be useful in those cases of composite wounds with
nerve lesions acting as a " nerve through flap " , in
order to reduce nerve adherence with a viable surrounding
gliding tissue.
A-1372 Routinely Measured Outcomes of Proximal
Row Carpectomy in Daily Practice: a Prospective
Cohort Study on 304 Patients part of the BSSH
Studyathon 2021
Joris S. Teunissen1,2, Liron S. Duraku3, Reinier Feitz1,2,
Michiel M. Zuidam3, Aaron Rooney4, Katharine Hamlin5,
Gulraj S. Matharu6, Yasmeen Khan5, Alexandra Haddon5,
Sophie Riesmeijer7, Bente van den Berge7, Isabel Theo8,
Gemma Smith8, Tim Hems9, Jennifer Lane8,
Ruud W. Selles3 and Robbert M. Wouters3
1Radboud University Medical Center, Nijmegen, The
Netherlands
2Xpert Clinics, Amsterdam, The Netherlands
3Erasmus Medical Center, Rotterdam, The Netherlands
4Norfolk and Norwich University Hospital, Norwich, UK
5NHS Grampian, Aberdeen, UK
6University of Bristol, Bristol, UK
7University Medical Center Groningen, Groningen, UK
8University of Oxford, Oxford, UK
9Queen Elizabeth University Hospital, Glasgow, UK
Objectives: To describe outcomes of Proximal Row
Carpectomy (PRC) performed for wrist arthritis in
terms of 1) patient-reported pain, hand- and wristfunction,
satisfaction, and return to work (RTW);
2) grip strength and range of wrist motion; and
3) postoperative complications.
Methods: This study was part of the British Society
for Surgery of the Hand (BSSH) Studyathon,
September 2021. During this collaboration, a
research team of the Hand Wrist Study Group and
participants of the BSSH Studyathon joined hands
to produce study results within a short time frame,
whilst providing education on the use of big data.
Prospectively collected PRC outcome data from
Xpert Clinics, the Netherlands was analyzed.
Outcomes were assessed using validated questionnaires
and measurements recommended by the
International Consortium for Health Outcome
Measurement (ICHOM). We compared preoperative
values with postoperative standardized time points
(baseline, 6 weeks, 3, 6, and 12 months postoperatively),
using linear mixed regression models.
Complications were scored according to the ICHOM
Complications in Hand and Wrist conditions.
Results: We included 304 patients who underwent
PRC; 73% for a SLAC wrist, 11% for a SNAC wrist,
11% for Kienb€ock disease, and 5% for other indications.
The total Patient Rated Wrist Hand Evaluation
(PRWHE) score improved from 60 (95% Confidence
Interval (CI): 57-63) to 25 (CI: 19-31). The pain subscale
improved by 18 (CI: 17-20) points, and the function
subscale by 16 (CI: 14-18) points. No differences
in PRWHE scores were found based on PRC indication,
or concomitant performance of a radial styloidectomy.
Satisfaction with treatment result at 12
months was excellent in 27%, good in 42%, fair in
20%, moderate in 6% and poor in 5%, and 85% of
the patients reported they would undergo PRC
again under similar circumstances. RTW at 12
months was 82% and the median time for return
was 12 (CI: 4-9) weeks. Grip strength returned to
the preoperative level by 12 months, and we found
a significant, but not clinically relevant, decrease in
wrist flexion and wrist extension. Complications
occurred in 31/304 (11%) of patients (3% grade I,
4% grade II, 0% grade IIIA, 4% grade IIIB, and 0%
grade IIIC).
Conclusion: PRC results in clinically relevant
improvements in patient-reported pain and function,
whilst maintaining wrist motion and grip strength.
This study informs clinicians of likely outcomes following
PRC to allow accurate discussion with
patients regarding the management of their wrist
arthritis.
A-1373 Accuracy of the 'shuck' test in the
assessment of distal radio-ulnar joint instability
Greg Pickering1, Nicola Fine2, Thomas Knapper1 and
Grey Giddins1
1Royal United Hospitals Bath NHS Foundation Trust,
Bath, UK
2Royal Devon and ExeterNHS Foundation Trust, Exeter, UK
Aims: The 'shuck' test (palmar-dorsal movement of
the ulnar relative to the radius) is the most commonly
used clinical test for distal radio-ulnar joint (DRUJ)
instability. We look to assess the accuracy of this
test, when utilised by a group of specialist hand surgeons,
in their assessment of DRUJ instability.
Methods: Thirty specialist hand surgeons (80% male,
80:20 orthopaedic:plastic surgery split) with a combined
total of 468 years consultant practice (range
1-35 years) assessed for instability both DRUJs of
four volunteers. Volunteers had been previously
tested with a validated measurement rig to assess
and quantify their DRUJ translation/instability.
Results: The diagnosis was correct in 142 of 240
assessments (59%). There were seven false positives
and 91 false negatives. The sensitivity of the test was
only 24% whilst the specificity was 94%. The positive
Journal of Hand Surgery - June 2022

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