PDF herunterladen
J Wrist Surg
DOI: 10.1055/s-0044-1786525
Scientific Article

Proximal Scaphoid Reconstruction Techniques Comparison of Three Techniques for Proximal Scaphoid Recontruction

Joseph A. Gil
1   Department of Orthopedic Surgery, Brown University, Providence, RI
,
Marion Burnier 
2   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Alexander Hooke 
2   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Bassem Elhassan
3   Department of Orthopedic Surgery, Harvard Medical School, Boston, Massachusetts
,
Sanjeev Kakar 
2   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
› Institutsangaben Funding This project was supported by the Mayo Clinic Biomechanics Core and by the Peter Formanek Foundation.
› Weitere Informationen
    Lizenzen und Reprints

Abstract

Introduction The costo-osteochondral autograft, vascularized medial femoral trochlear osteochondral autograft, and proximal hamate autograft have been used for the reconstruction of unsalvageable proximal pole scaphoid nonunions. Our hypothesis is that there is no difference in carpal kinematics after the proximal pole of the scaphoid is reconstructed with these three graft options.

Methods Wireless sensors were mounted to the carpus that was loaded through cyclical motion. Each specimen was tested under a series of the three reconstructed conditions and their kinematics compared.

Results No significant differences were found in scapholunate and lunocapitate joint motion during wrist flexion-extension and wrist radioulnar deviation between the three reconstructed conditions (p > 0.05).

Discussion and Conclusion There are minimal differences in carpal kinematics when comparing reconstruction of the proximal pole of the scaphoid with the costoosteochondral, medial femoral trochlear, and proximal hamate grafts.

Keywords

biomechanical comparison - proximal scaphoid reconstruction - proximal hamate - medial femoral trochlea - costo-osteochondral grafts - scaphoid fracture - proximal pole - nonunion

Authors' Contributions

All the named authors were actively involved in the planning, enactment, and writing up of the study.


Informed Consent

Informed consent was obtained for this study.


Study Type

This is a biomechanics study.


Clinical Relevance

Knowledge of the effect of the various reconstructions for unsalvageable proximal pole scaphoid nonunions may guide surgeons as to what procedure they may perform.


Trial Registration

Not applicable




Publikationsverlauf

Eingereicht: 01. März 2023

Angenommen: 03. April 2024

Artikel online veröffentlicht:
27. Mai 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Aibinder WR, Wagner ER, Bishop AT, Shin AY. Bone grafting for scaphoid nonunions: is free vascularized bone grafting superior for scaphoid nonunion?. Hand (N Y) 2019; 14 (02) 217-222
    CrossrefPubMedGoogle Scholar
  • 2 Duckworth AD, Jenkins PJ, Aitken SA, Clement ND, Court-Brown CM, McQueen MM. Scaphoid fracture epidemiology. J Trauma Acute Care Surg 2012; 72 (02) E41-E45
    CrossrefPubMedGoogle Scholar
  • 3 Dy CJ, Kazmers NH, Baty J, Bommarito K, Osei DA. An epidemiologic perspective on scaphoid fracture treatment and frequency of nonunion surgery in the USA. HSS J 2018; 14 (03) 245-250
    CrossrefPubMedGoogle Scholar
  • 4 Jonsson BY, Siggeirsdottir K, Mogensen B, Sigvaldason H, Sigursson G. Fracture rate in a population-based sample of men in Reykjavik. Acta Orthop Scand 2004; 75 (02) 195-200
    CrossrefPubMedGoogle Scholar
  • 5 Larsen CF, Brøndum V, Skov O. Epidemiology of scaphoid fractures in Odense, Denmark. Acta Orthop Scand 1992; 63 (02) 216-218
    CrossrefPubMedGoogle Scholar
  • 6 Raittio LT, Jokihaara J, Huttunen TT, Leppänen OV, Launonen AP, Mattila VM. Rising incidence of scaphoid fracture surgery in Finland. J Hand Surg Eur Vol 2018; 43 (04) 402-406
    CrossrefPubMedGoogle Scholar
  • 7 Van Tassel DC, Owens BD, Wolf JM. Incidence estimates and demographics of scaphoid fracture in the U.S. population. J Hand Surg Am 2010; 35 (08) 1242-1245
    CrossrefPubMedGoogle Scholar
  • 8 Zura R, Xiong Z, Einhorn T. et al. Epidemiology of fracture nonunion in 18 human bones. JAMA Surg 2016; 151 (11) e162775
    CrossrefPubMedGoogle Scholar
  • 9 Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg Am 1980; 5 (05) 508-513
    CrossrefPubMedGoogle Scholar
  • 10 Derby BM, Murray PM, Shin AY. et al. Vascularized bone grafts for the treatment of carpal bone pathology. Hand (N Y) 2013; 8 (01) 27-40
    CrossrefPubMedGoogle Scholar
  • 11 Kakar S, Greene RM, Hewett T, Thoreson AR, Hooke AW, Elhassan BT. The effect of proximal hamate osteotomy on carpal kinematics for reconstruction of proximal pole scaphoid nonunion with avascular necrosis. Hand (N Y) 2020; 15 (03) 371-377
    CrossrefPubMedGoogle Scholar
  • 12 Bürger HK, Windhofer C, Gaggl AJ, Higgins JP. Vascularized medial femoral trochlea osteocartilaginous flap reconstruction of proximal pole scaphoid nonunions. J Hand Surg Am 2013; 38 (04) 690-700
    CrossrefPubMedGoogle Scholar
  • 13 Elhassan B, Noureldin M, Kakar S. Proximal scaphoid pole reconstruction utilizing ipsilateral proximal hamate autograft. Hand (N Y) 2016; 11 (04) 495-499
    CrossrefPubMedGoogle Scholar
  • 14 Yao J, Read B, Hentz VR. The fragmented proximal pole scaphoid nonunion treated with rib autograft: case series and review of the literature. J Hand Surg Am 2013; 38 (11) 2188-2192
    CrossrefPubMedGoogle Scholar
  • 15 Sandow MJ. Proximal scaphoid costo-osteochondral replacement arthroplasty. J Hand Surg [Br] 1998; 23 (02) 201-208
    CrossrefPubMedGoogle Scholar
  • 16 Garcia-Elias M, Lluch A. Partial excision of scaphoid: is it ever indicated?. Hand Clin 2001; 17 (04) 687-695 , x
    CrossrefPubMedGoogle Scholar
  • 17 Carter PR, Malinin TI, Abbey PA, Sommerkamp TG. The scaphoid allograft: a new operation for treatment of the very proximal scaphoid nonunion or for the necrotic, fragmented scaphoid proximal pole. J Hand Surg Am 1989; 14 (01) 1-12
    CrossrefPubMedGoogle Scholar
  • 18 Ritt MJ, Berger RA, Kauer JM. The gross and histologic anatomy of the ligaments of the capitohamate joint. J Hand Surg Am 1996; 21 (06) 1022-1028
    CrossrefPubMedGoogle Scholar
  • 19 Wu K, Padmore C, Lalone E, Suh N. An anthropometric assessment of the proximal hamate autograft for scaphoid proximal pole reconstruction. J Hand Surg Am 2019; 44 (01) 60.e1-60.e8
    CrossrefPubMedGoogle Scholar