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Proximal scaphoid rib graft arthroplasty.

S Veitch¹, S M Blake, H David

¹Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK. swveitch@doctors.org.uk

The Journal of Bone and Joint Surgery. British Volume

|February 27, 2007

Summary

Rib osteochondral grafting effectively treats proximal scaphoid pole deficiency, restoring wrist function and grip strength. This surgical technique offers a satisfactory solution, avoiding complications of other treatments.

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Area of Science:

Orthopedic Surgery
Hand Surgery
Regenerative Medicine

Background:

Proximal pole scaphoid deficiency presents a significant challenge in hand function.
Current treatment options have limitations, including complications and suboptimal outcomes.

Purpose of the Study:

To evaluate the efficacy of rib osteochondral replacement arthroplasty for proximal scaphoid pole deficiency.
To assess functional recovery, pain reduction, and maintenance of wrist motion post-surgery.

Main Methods:

Prospective review of 14 patients undergoing rib osteochondral arthroplasty for proximal scaphoid pole deficiency.
Assessment of wrist function using the modified Green and O'Brien wrist function score.
Evaluation of grip strength, pain levels, carpal alignment, and complications.

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Main Results:

Significant improvement in wrist function in 13 of 14 patients (93%).
Enhanced grip strength, reduced pain, and maintained wrist movement observed.
Mean wrist function score improved from 54 pre-operatively to 79 post-operatively.
No deterioration in carpal alignment and no nonunion or major complications reported.

Conclusions:

Rib osteochondral replacement arthroplasty effectively restores mechanical integrity of the proximal scaphoid pole.
The procedure provides satisfactory functional restoration and maintains wrist mobility.
This technique avoids complications associated with alternative arthroplasty methods, vascularized grafts, and salvage procedures.