Transcarpal Amputation
- Retain flexion/extension of wrist
- Wrist flexor and extensor tendons are tenodesed to remaining carpus to allow for this
- Longer lever arm but harder to fit prosthesis
- Long full thickness palmar flap and shorter dorsal flap in 2:1 ratio
- Median/ulnar nerves sectioned + retract
- Radial nerve divided into fine filaments and each is sectioned
- Radial/ulnar arteries ligated
- Use finger tendons for bony coverage
Wrist Disarticulation
- Similar to transcarpal amp but lose wrist flex/ext
- Can rasp prominence of styloid processes (maintain radial styloid height for prosthesis fitting though)
- Can doubly ligate medial/ulnar/SRN proximally in forearm to reduce neuroma chance
- Protect DRUJ + TFCC for normal pronation/supination
- Better for paediatrics — retains distal radial/ulnar physis for normal growth of stump and prevents terminal overgrowth
Author Contributions
Page written by Dr James Drummond
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.