Subscribe to RSS
A Morphometric Analysis of Hamate Autograft for Proximal Scaphoid ReconstructionFunding None.
Objective Recently, authors have investigated using the proximal hamate as osteochondral autograft for proximal pole scaphoid reconstruction in the case of nonunion with avascular necrosis. The aim of our study was to analyze the morphology and anatomic fit of the proximal hamate compared with the proximal pole of the scaphoid using cadaveric specimens.
Materials and Methods Ten cadaver specimens (five males and five females) were dissected. Scaphoid and proximal hamate bones were measured by two independent investigators using electronic calipers and radius of curvature gauges. After measurements were determined to have good correlation, the average value of the two observers' measurements were used for further analysis. Sagittal radius of curvature (ROC), coronal ROC, depth, width, and maximum graft length were compared.
Results The average depth of the scaphoid proximal pole was 12.3 mm (standard deviation [SD] = 1.12) compared with 11.3 mm (SD = 1.24) for the proximal hamate (p = 0.36). The average width was 7.8 mm (SD = 1.00) in the scaphoids compared with 8.6 (SD = 1.05) in the hamates (p = 0.09). There was also no significant difference in the sagittal ROC between hamates (9.1 mm, SD = 1.13) and scaphoids (9.5 mm, SD = 0.84; p = 0.36). All of these average measurements were within 1 mm. There was a significant difference between the coronal ROC of the hamate (23.4 mm) and scaphoid (21.1 mm) bones in our samples (p = 0.03). Females were on average smaller than their males, but there was no significant difference in fit based on sex alone.
Conclusion The proximal pole of the hamate has similar morphology and size as the scaphoid, with similar depth, width, and sagittal ROC. It has potential as an osteochondral autograft for proximal pole scaphoid reconstruction.
Received: 01 December 2019
Accepted: 08 February 2021
Article published online:
14 April 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
- 1 Pinder RM, Brkljac M, Rix L, Muir L, Brewster M. Treatment of scaphoid nonunion: a systematic review of the existing evidence. J Hand Surg Am 2015; 40 (09) 1797-1805.e3
- 2 Gelberman RH, Menon J. The vascularity of the scaphoid bone. J Hand Surg Am 1980; 5 (05) 508-513
- 3 Bürger HK, Windhofer C, Gaggl AJ, Higgins JP. Vascularized medial femoral trochlea osteocartilaginous flap reconstruction of proximal pole scaphoid nonunions. J Hand Surg Am 2013; 38 (04) 690-700
- 4 Veitch S, Blake SM, David H. Proximal scaphoid rib graft arthroplasty. J Bone Joint Surg Br 2007; 89 (02) 196-201
- 5 Yao J, Read B, Hentz VR. The fragmented proximal pole scaphoid nonunion treated with rib autograft: case series and review of the literature. J Hand Surg Am 2013; 38 (11) 2188-2192
- 6 Elhassan B, Noureldin M, Kakar S. Proximal scaphoid pole reconstruction utilizing ipsilateral proximal hamate autograft. Hand (N Y) 2016; 11 (04) 495-499
- 7 Chang MA, Bishop AT, Moran SL, Shin AY. The outcomes and complications of 1,2-intercompartmental supraretinacular artery pedicled vascularized bone grafting of scaphoid nonunions. J Hand Surg Am 2006; 31 (03) 387-396
- 8 Lim TK, Kim HK, Koh KH, Lee HI, Woo SJ, Park MJ. Treatment of avascular proximal pole scaphoid nonunions with vascularized distal radius bone grafting. J Hand Surg Am 2013; 38 (10) 1906-12.e1
- 9 Robbins RR, Ridge O, Carter PR. Iliac crest bone grafting and Herbert screw fixation of nonunions of the scaphoid with avascular proximal poles. J Hand Surg Am 1995; 20 (05) 818-831
- 10 Luchetti TJ, Rao AJ, Fernandez JJ, Cohen MS, Wysocki RW. Fixation of proximal pole scaphoid nonunion with non-vascularized cancellous autograft. J Hand Surg Eur Vol 2018; 43 (01) 66-72
- 11 Ditsios K, Konstantinidis I, Agas K, Christodoulou A. Comparative meta-analysis on the various vascularized bone flaps used for the treatment of scaphoid nonunion. J Orthop Res 2017; 35 (05) 1076-1085
- 12 Zaidemberg C, Siebert JW, Angrigiani C. A new vascularized bone graft for scaphoid nonunion. J Hand Surg Am 1991; 16 (03) 474-478
- 13 Son JH, Giladi AM, Higgins JP. Iatrogenic femur fracture following medial femoral condyle flap harvest eventually requiring total knee arthroplasty in one patient. J Hand Surg Eur Vol 2019; 44 (03) 320-321
- 14 Giladi AM, Rinkinen JR, Higgins JP, Iorio ML. Donor-site morbidity of vascularized bone flaps from the distal femur: a systematic review. Plast Reconstr Surg 2018; 142 (03) 363e-372e
- 15 Wu K, Padmore C, Lalone E, Suh N. An anthropometric assessment of the proximal hamate autograft for scaphoid proximal pole reconstruction. J Hand Surg Am 2019; 44 (01) 60.e1-60.e8
- 16 Kakar S, Greene RM, Elhassan BT, Holmes III DR. Topographical analysis of the hamate for proximal pole scaphoid nonunion reconstruction. J Hand Surg Am 2020; 45 (01) 69.e1-69.e7
- 17 Harley BJ, Werner FW, Boles SD, Palmer AK. Arthroscopic resection of arthrosis of the proximal hamate: a clinical and biomechanical study. J Hand Surg Am 2004; 29 (04) 661-667
- 18 Kakar S, Greene RM, Hewett T, Thoreson AR, Hooke AW, Elhassan BT. The effect of proximal hamate osteotomy on carpal kinematics for reconstruction of proximal pole scaphoid nonunion with avascular necrosis. Hand (N Y) 2020; 15 (03) 371-377