- Discussion:
- limited fusion of the capitate to the hamate has also been used successfully to prevent carpal collapse;
- however, following this procedure, grip strength is slow to return;
- some believe that this is a poor treatment option, since it does not cross both carpal rows, and consequently is ineffective in causing
transfer load to the ulnar side of the wrist;
- capitate shortening w/ captiate-hamate fusion:
- may increase scaphoid loading by 20%;
- captitate is shortened about 3 mm;
- proximal pole of hamate is removed to prevent hamate-lunate articulation;
- Technique:
- fusion is accomplished through a dorsal approach, decorticating adjacent surface of the capitate and hamate and packing this w/
cancellous bone;
- slotted corticocancellous graft is then compressed between capitate and hamate;
- six weeks of short-arm immobilization follows
Biomechanical analysis of capitate shortening with captiate hamate fusion in the treatment of Kienbock's disease.