1. Proximal Hamate Reconstruction of Proximal Pole Scaphoid Nonunion: A Case Series and Analysis of Clinical Outcomes.
- Author
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Rodriguez-Fontan F, Tucker NJ, Pflug EM, Leversedge FJ, Catalano LW, and Lauder A
- Subjects
- Humans, Male, Retrospective Studies, Female, Adult, Young Adult, Bone Transplantation methods, Treatment Outcome, Disability Evaluation, Transplantation, Autologous, Scaphoid Bone surgery, Scaphoid Bone injuries, Fractures, Ununited surgery, Fractures, Ununited diagnostic imaging, Range of Motion, Articular, Hamate Bone surgery, Hamate Bone transplantation
- Abstract
Background: Small proximal pole scaphoid nonunions present a clinical challenge influenced by fragment size, vascular compromise, deforming forces exerted through the scapholunate interosseous ligament (SLIL), and potential articular fragmentation. Osteochondral autograft options for proximal pole reconstruction include the medial femoral trochlea, costochondral rib, or proximal hamate. This study reports the clinical outcomes of patients treated with proximal hamate osteochondral autograft reconstruction., Methods: A retrospective review identified patients treated with this surgery from 2 institutions with a minimum 6-month follow-up. Clinical outcomes included the Visual Analog Dcale pain score, 12-item Short-Form survey, abbreviated Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, wrist and forearm range of motion (ROM), radiographic assessment, and complications. We reviewed and compared these outcomes with those of the current published literature., Results: Four patients (mean age: 24 years, 75% men) with a 12.8-month average follow-up (range: 6-20 months) were included. Radiographic union was identified in all cases by 12 weeks (range, 10-12). The average wrist ROM was 67.5% flexion/extension and 100% pronation/supination compared with the contralateral side at the final follow-up. The mean QuickDASH score was 17.6 (SD, 13). No complications were identified., Conclusions: Proximal pole scaphoid nonunion reconstruction using autologous proximal hamate osteochondral graft demonstrated encouraging clinical and radiographic outcomes. Proximal hamate harvest involves minimal donor site morbidity without a distant operative site, uses an osteochondral graft with similar morphology to the proximal scaphoid, requires no microsurgical technique, and permits reconstruction of the SLIL using the volar capitohamate ligament., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Case 4 included in this series has been previously published elsewhere (Merkow D, Rocks M, Ryan D, Shaughnessy P, Catalano L. Proximal Hamate Autograft for Proximal Scaphoid Pole Reconstruction A Case Report. Bull Hosp Jt Dis (2013). 2022 Jun;80(2):155-159. PMID: 35643475). The prior publication was a case report with a shorter follow-up. The case was included in our current case series with new collected data and a longer follow-up and represents new original work/outcomes of one of the authors (L.W.C.).
- Published
- 2024
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