Proximal scaphoid rib graft arthroplasty.

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.

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.