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

J Wrist Surg. 2024 May 27;13(5):421-426. doi: 10.1055/s-0044-1786525. eCollection 2024 Oct.

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; costo-osteochondral grafts; medial femoral trochlea; nonunion; proximal hamate; proximal pole; proximal scaphoid reconstruction; scaphoid fracture.

Grants and funding

Funding This project was supported by the Mayo Clinic Biomechanics Core and by the Peter Formanek Foundation.