The Use of the Proximal Hamate as an Autograft for Proximal Pole Scaphoid Fractures

Kandil, Wael; Essawy, Osama; Tabl, Eslam; El-Gazzar, Esmail Araby

doi:10.21608/bjas.2025.342787.1549

The Use of the Proximal Hamate as an Autograft for Proximal Pole Scaphoid Fractures

Document Type : Original Research Papers

Authors

¹ Professor of Orthopaedic Surgery Faculty of Medicine - Benha University

² Professor of Orthopedic Surgery, Faculty of Medicine, Benha University

³ Assistant Professor of Orthopaedic Surgery Faculty of Medicine - Benha University

⁴ Department of Orthopaedic Surgery Faculty of Medicine - Benha University

10.21608/bjas.2025.342787.1549

Abstract

Background: Because of the fragile blood supply and tiny size of the proximal fragment, scaphoid fractures are difficult to treat. Recently, proximal hamate has been employed as a replacement arthroplasty for proximal pole nonunions accompanied by collapse, bone loss, and/or osteonecrosis.
Aim: so that we may assess how well proximal Hamate autograft treats proximal pole scaphoid fractures.
Methods: Twenty patients in a row with proximal pole scaphoid fractures or nonunion accompanied by collapse, bone loss, or osteonecrosis AVN were the subjects of this prospective case study. Only patients with fully developed skeletons are eligible. All patients were evaluated radiologically, with X-rays providing a true AP, lateral, and scaphoid view; CT scans helping to define fracture pattern, carpal alignment, and arthritis; and MRIs evaluating vascularity and the viability of the proximal pole. The average duration of follow-up for all patients was eleven months, with a range of nine to fourteen months.
Results: The VAS after surgery was much lower than the VAS before surgery. When comparing the Mayo score index before and after surgery, there was a significant improvement. The relationship between union time, graft size, and time to remove wires was not statistically significant.
Conclusions: Alternative treatment approaches for proximal pole scaphoid fractures, such as the nonvascularized hamate proximal pole, show promise.
One of the critical tasks to carry out the procedure well is to probe the graft size and harvest the capito-Hamate ligament.

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