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The Carpal Boss

A 20-year review of Operative Management

From the Section of Plastic and Reconstructive Surgery, Yale University School of Medicine and the Hand Surgery Service, University of Connecticut and Hartford Hospital, Hartford, CT, USA

Correspondence: Stefano Fusi, MD, Connecticut Center for Plastic Surgery, 60 Temple Street, New Haven, CT 06510, USA.

Between 1969 and 1989,116 patients were evaluated and treated surgically for symptomatic carpal boss. Their mean age was 32 years and male and female patients were equally affected. 28 patients gave a history of previous injury. Surgical treatment consisted of excision of the localized bony abnormality and the associated degenerative arthritic process to the level of normal articular surfaces and normal adjacent cancellous bone. The mean follow-up period for the patients in this study was 42 months. Complete symptomatic relief was observed in 94% of the patients undergoing surgical treatment. Recurrence or persistence of symptoms developed in seven surgical patients. Six had a second operation with more extensive removal of sclerotic bone and degenerate cartilage, and all patients had relief of symptoms.

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