Proximal Row Carpectomy — Wrist Proximal Row Carpectomy

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE; no WB

Key Restrictions

No strengthening until 6 weeks; no WB; avoid composite wrist/digit flexibility exercises (prevents extrinsic stretching); avoid forceful wrist manipulation; heavy lifting contraindicated long-term; avoid EDC compensatory activity for wrist extension

Timeline & Phases

Phase 1 (0-2 wks): volar wrist splint; Phase 2 (2-4 wks): short arm cast or full-time wrist orthosis, address finger lag, light dexterity; Phase 3 (4-8 wks): wrist 4-way AROM, isolated wrist extension (avoid EDC compensation), forearm rotation, isometric wrist from wk 6, orthosis for light sedentary ADLs from wk 6; Phase 4 (8-12 wks): wean orthosis, return to full ADLs excluding heavy lifting

Notes

4 phases; avoid EDC compensatory activity for wrist extension; avoid composite wrist/digit flexibility; heavy lifting (e.g., construction) excluded long-term; gravity-assisted wrist motion; no forceful wrist manipulation to regain ROM; compression sleeve/wrist wrap for comfort during weaning

Published

09/2024