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Distal Scaphoid Excision and Dermal Allograft Interposition in a Professional Athlete: Long-term Follow-up
Eva A Williams1, Linda Chao2, Eunise Chen3
1From the Keck School of Medicine, Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, Calif.
Plastic and Reconstructive Surgery. Global Open
|August 22, 2024
Summary
Human acellular dermal matrix effectively treated stage I scaphoid nonunion advanced collapse after distal scaphoid excision. This innovative approach restored carpal height and resolved pain, allowing a full return to activity within 6 weeks.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Regenerative medicine
Background:
- Scaphoid nonunion occurs in 10%-15% of scaphoid fractures.
- Scaphoid nonunion can lead to scaphoid nonunion advanced collapse (SNAC).
- Distal scaphoid excision is a treatment option for SNAC, but may cause carpal height loss and pain without interposition grafting.
Observation:
- This case report details the use of human acellular dermal matrix (HADM) as an interposition graft.
- HADM was applied after distal scaphoid excision in a patient with stage I SNAC.
- The patient underwent early range of motion postoperatively.
Findings:
- The patient returned to full activity at 6 weeks post-surgery.
- Significant pain resolution was observed 6 years after the procedure.
- HADM interposition successfully addressed the limitations of distal scaphoid excision alone.
Implications:
- Human acellular dermal matrix presents a viable alternative for interposition grafting in scaphoid nonunion advanced collapse.
- This technique may preserve carpal height and alleviate pain, improving patient outcomes.
- Further research into HADM for scaphoid reconstruction is warranted.
