Proximal Pole Scaphoid Reconstruction Using Proximal Hamate

Summary

Recently, A novel surgical technique was illustrated by Elhassan BT et al. in 2016 utilizing the Hemi-hamate autograft for the reconstruction of scaphoid bone proximal pole non-union with avascular necrosis.

The technique showed promising results but is still limited to case reports and anatomical studies

In this study, we aim to:

1. Evaluate the surgical technique steps and suggest any possible modifications to the original description of the technique.
2. Assessment of clinical outcomes of this novel technique in terms of; bone union rate, time to union, and wrist function.
3. Report any complications of the usage of the proximal hamate for the proximal pole of the scaphoid reconstruction.

Conditions

• Closed Fracture Scaphoid, Proximal Pole
• A Proximal Pole of Scaphoid That is Deemed Unsalvageable

Interventions

PROCEDURE

Hemi-Hamate Transfer for Proximal Pole Scaphoid Reconstruction

Surgical Technique: The participants will be positioned in the supine decubitus on the surgical table with the operated upper limb put on a C-arm (Mobile fluoroscopy device) compatible surgical arm-board. After anesthesia, a pneumatic tourniquet will be placed with a cuff pressure raised to 250 mmHg, then the limb is draped in the regular sterile fashion. Through a dorsal approach to the wrist joint, the proximal pole of scaphoid bone will be assessed before resectioning for confirmation that it cannot be preserved. The hamate bone will be exposed through capsulotomy and the measurements of the resected scaphoid will be transferred. The harvested H-H autograft will be placed and fixed to the distal scaphoid segment. Wound closure is then performed in layers in the usual fashion, and the wound will be covered by a sterile gauze, then a short-arm thumb spica splint will be put on.

Sponsors & Collaborators

• Ain Shams University

  lead OTHER

Principal Investigators

• Ahmed Mohamed Ashraf Abdelfatah Rabie, Orthopedic Surgery Specialist, · Ain Shams University

• Ayman Ibrahim Fathy Aly Hewaidy, Professor of Orthopedic Surgery, · Faculty of Medicine, Ain Shams University

• Ahmed Naeem Atiyya Aly, Professor of Orthopedic Surgery, · Faculty of Medicine, Ain Shams University

• Amr Mostafa Mohamed Aly, Assistant Professor of Orthopedic Surgery, · Faculty of Medicine, Ain Shams University

• Ramy Ahmed Aly Soliman, Lecturer of Orthopedic Surgery, · Faculty of Medicine, Ain Shams University

Study Design

Allocation

NA

Purpose

TREATMENT

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-03-15

Primary Completion

2022-09-30

Completion

2023-09-30

Countries

• Egypt

Study Locations