Background: Because of the fragile blood supply and tiny size of the proximal fragment,
scaphoid fractures are difficult to treat. Recently, proximal hamate has been employed as a
replacement arthroplasty for proximal pole nonunions accompanied by collapse, bone loss,
and/or osteonecrosis.
Aim: so that we may assess how well proximal Hamate autograft treats proximal pole
scaphoid fractures.
Methods: Twenty patients in a row with proximal pole scaphoid fractures or nonunion
accompanied by collapse, bone loss, or osteonecrosis AVN were the subjects of this
prospective case study. Only patients with fully developed skeletons are eligible. All patients
were evaluated radiologically, with X-rays providing a true AP, lateral, and scaphoid view;
CT scans helping to define fracture pattern, carpal alignment, and arthritis; and MRIs
evaluating vascularity and the viability of the proximal pole. The average duration of followup for all patients was eleven months, with a range of nine to fourteen months.
Results: The VAS after surgery was much lower than the VAS before surgery. When
comparing the Mayo score index before and after surgery, there was a significant
improvement. The relationship between union time, graft size, and time to remove wires was
not statistically significant.
Conclusions: Alternative treatment approaches for proximal pole scaphoid fractures, such as
the nonvascularized hamate proximal pole, show promise.
One of the critical tasks to carry out the procedure well is to probe the graft size and harvest
the capito-Hamate ligament. |
