Partial excision of scaphoid: is it ever indicated?
The carpal scaphoid cannot be partially or totally excised without paying a functional penalty, usually in the form of carpal instability. In selected conditions, however, a partial scaphoidectomy may be preferred over other less reliable alternatives. These include excision of a small fragment of a fractured proximal pole when there is no injury to the scapholunate ligaments; excision of the distal fragment of a nonunited, arthritic distal-third scaphoid fracture; resection-arthroplasty of isolated STT osteoarthritis; and distal scaphoid excision to improve midcarpal function after a radioscapholunate fusion. In this article, both the pathomechanics and clinical results of such techniques are discussed.
Garcia-Elias
M
M
Institut Kaplan, Hand and Upper Extremity Surgery, Barcelona, Spain. garciaelias@infonegocio.com
Lluch
A
A
D001174:Arthrodesis / Q000379:methods*; D001696:Biomechanical Phenomena; D002348:Carpal Bones / Q000503:physiopathology; D005596:Fractures, Closed / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology; D010003:Osteoarthritis / Q000209:etiology / Q000601:surgery; D021361:Scaphoid Bone / Q000293:injuries* / Q000601:surgery*; D014955:Wrist Joint / Q000503:physiopathology