Arthroscopic proximal pole resection, partial scaphoid implant
Epublication WebSurg.com, Oct 2011;11(10). URL: http://websurg.com/doi/lt03enhaerle001
Proximal pole necrosis of the scaphoid can occur after scaphoid fractures. The replacement of the proximal pole has been tried using many different materials for many years, according to the literature. This technique consists in an arthroscopic debridement of the proximal scaphoid pole, leaving the local ligaments as intact as possible. The proximal pole is substituted by a pyrolitic carbon implant, which has an ovoid shape and fits well into this position. We present the technique and the results of 23 of Prof. Christophe Mathoulin’s patients treated between 1998 and 2007 with 21 good results and only one palmar implant dislocation. Even though good results have been already published in the literature, these results seem closely related to the degree of instability, created by the ligament damage in the scapho-lunate area. This treatment is therefore a salvage procedure more indicated in elderly people than in young people. On the other hand, it can be a simple and convenient waiting therapy option in other cases.