Non-repairable Scaphoid Proximal Pole Nonunion Reconstruction by Hamate Arthroplasty: A Case Series Study

Objectives: Non-repairable scaphoid proximal pole nonunion remains a major challenge. Various reconstructive surgical approaches have been introduced, but each one has some limitations, including microvascular anastomosis, donor site morbidities, and the risk of compromising the scapholunate ligament.Methods: This prospective interventional case series was performed on five patients. The patients underwent reconstructive surgery using proximal hamate arthroplasty by a single surgeon and were followed up for at least ۱۲ months.Results: All patients were male and the median age was ۲۸, and the median follow-up time was ۲۴ months. The median Mayo score was ۷۰, and the DASH score was ۰ (no disability) in ۳ patients and ۱۵ in two patients. The median of postoperative grip strength in the operated hands was ۳۷.۳ kg (Range ۳۶.۱–۳۹) and in the opposite hands was ۴۲.۵ kg (Range ۴۰–۴۵.۹). However, there were significant differences between grip strength between operated and opposite hands (P value= ۰.۰۰۸). A reduction of ۱۱.۱% and ۱۵% was shown in postoperative flexion and extension compared with preoperative flexion and extension (P value = ۰.۱۹۴, P value = ۰.۱۰۲).Conclusion: Hamate arthroplasty for nonunion of the scaphoid proximal pole appears to be a viable surgical option with favorable outcomes in terms of union rates, functional recovery, and patient satisfaction. Level of evidence: IV

کلیدواژه ها:

Arthroplasty ، nonunion ، proximal scaphoid pole fracture ، Reconstruction ، Scaphoid fracture