Ipsilateral Hamate Autograft for Proximal Scaphoid Pole Injuries

Description

This video presents a detailed surgical procedure for the reconstruction of the scaphoid proximal pole using a proximal hamate autograft. Conducted by Rachel Milam, the video outlines the complex challenges posed by unreconstructed scaphoid fractures in traumatic cases. The presentation covers indications for surgery, patient selection, and alternative graft options, highlighting two specific patients—both active duty individuals—who required the procedure due to comminuted proximal pole fractures.



The narrative includes crucial surgical steps, starting from the dorsal approach to the wrist, through tendon transpositions, and ligament considerations, to meticulous graft harvesting from the hamate bone. Key principles of measurement and fitting the hamate graft to the scaphoid defect are emphasized, alongside intraoperative techniques such as capsulotomy and the preservation of critical ligaments.



The video also discusses post-operative care, immobilization methods, and scheduled follow-up assessments, providing insights into healing timelines and functional outcomes. Preliminary results show promising recovery and restoration of wrist functionality for the patients involved, underscoring the hamate graft's benefits and potential surgical risks. Overall, this instructional video serves as a valuable resource for orthopedic surgeons engaged in complex wrist reconstructions.

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