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J Wrist Surg 2024; 13(05): 421-426
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
› Author Affiliations
Funding This project was supported by the Mayo Clinic Biomechanics Core and by the Peter Formanek Foundation.
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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




Publication History

Received: 01 March 2023

Accepted: 03 April 2024

Article published online:
27 May 2024

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