Treatment of unstable dorsal proximal interphalangeal fracture/dislocations using a hemi-hamate autograft

Williams, Rafael M M; Kiefhaber, Thomas R.; Sommerkamp, T. Greg; Stern, Peter J.

doi:10.1016/s0363-5023(03)00304-6

Cited by 194 publications

(155 citation statements)

References 19 publications

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“…[38][39][40][41][42] Sandow advocated costo-osteochondral (rib bone/cartilage autograft) replacement for the proximal scaphoid. 43 Furthermore, the distal fibula has been used to reconstruct the distal radius after giant cell tumor resection.…”

Section: Discussionmentioning

confidence: 99%

Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Tang

Imbriglia

2013

Jnl Wrist Surg

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Proximal row carpectomy (PRC) has been shown in multiple studies to be an effective motion-preserving procedure for wrist arthritis. The operation consists of resection of the scaphoid, lunate, and triquetrum. 1 The proximal capitate and lunate fossa of the radius form the new wrist articulation, which makes the ideal patient free of degenerative changes at those articular surfaces. 2-8 Various authors, as well as the senior author, have maintained that when there is mild degeneration of these articular surfaces, PRC can still provide good to excellent results. [2][3][4][5][6]9 However, as wrist arthritis progresses, as in stage III scapholunate advanced collapse (SLAC) wrist or stage II/III scaphoid nonunion advanced collapse (SNAC) wrist, the proximal capitate becomes arthritic. With advanced degeneration, alternative surgical procedures include scaphoid excision, four-bone fusion, and wrist fusion. However, there Keywords ► osteochondral graft ► proximal row carpectomy AbstractBackground Proximal row carpectomy (PRC) is a useful treatment option for wrist arthritis, but the operation is contraindicated when there is arthritis of the capitate head. We describe a technique that involves resurfacing of a capitate that has focal chondrosis, using an osteochondral graft harvested from the resected carpal bones. Materials and Methods PRC patients who had a focal area of capitate chondrosis underwent osteochondral grafting of the capitate. Pre-and postoperative pain level, employment status, motion, grip strength, and Modified Mayo Wrist Scores (MMWS) were assessed. Postoperative Disability of the Arm, Shoulder, and Hand (DASH) scores were also calculated.

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Section: Discussionmentioning

confidence: 99%

Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Tang

Imbriglia

2013

Jnl Wrist Surg

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“…This could prove useful in clinical situations: for example, to reduce the risk of failure and collapse after loadbearing osteochondral grafts such as whole-joint transfer, mosaic-plasty or hamate repair of PIP fractures (Williams et al 2003).…”

Section: Discussionmentioning

confidence: 99%

Systemic zoledronate precoating of a bone graft reduces bone resorption during remodeling

2006

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Background Cartilage degeneration often occurs after osteosynthesis of a devascularized intermediary fragment in a joint fracture, in mosaic-plasty or in wholejoint toe-to-finger transplantation. Hypothetically, the degeneration is secondary to a collapse of the transferred subchondral bone as it remodels during high mechanical load. Bisphosphonates are used to reduce resorption of necrotic bone. We tested a systemic pretreatment before harvesting the graft in order to protect the bone and cartilage against collapse and secondary arthrosis.Methods Rats were given one zoledronate injection and bone grafts were harvested. The grafts were frozen, thawed and placed into bone chambers, and implanted into another batch of rats. Graft resorption and new bone formation was measured by histomorphometric analysis and compared with untreated grafts.Results In the remodeled area of the controls, the graft was almost totally resorbed and replaced by bone marrow. In the zoledronate-treated specimens, the graft remained and the graft trabeculas were lined with new bone. By histomorphometry, the total amount of bone (graft plus new bone) within the remodeled area was 16% in the zoledronate-treated grafts and 5% in the controls (p = 0.003).Interpretation A bone graft can be pretreated with bisphosphonate and remain protected against resorption once implanted again.

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“…Active/effective range of movement (arc) Complications Bain et al [ 15 ] ORIF or VPA and then monolateral ex-fi x 222 days 65.6° 1 septic arthritis 2 pin track infection Deshmukh et al [ 16 ] Fracture displacement ORIF 2 × residual subluxation Rutland et al [ 11 ] Dynamic ex fi x 16 months 89° 8 pin track infections Waris et al [ 10 ] Dorsal blocking wire 5 years 83° None reported Williams et al [ 24 ] Hemi-hamate autograft 16 months 85° 2 recurrent subluxation Durhan-Smith et al [ 25 ] Volar plate arthroplasty Minimum 6 months 95° 3 dorsal skin necrosis 1 pin track infection Hamer et al [ 26 ] Extension block splint 20.6 months 87° 3 treatment failure requiring surgery Newington et al [ 27 ] …”

Section: Authorsmentioning

confidence: 99%