- Training
- 15/05/2022
- USA
Proximal Hamate to Scaphoid Nonunion Reconstruction
Description
The video presentation by Dr. David Tuckman details a surgical procedure for proximal pole scaphoid reconstruction utilizing a handmade osteoarticular autograft. The case involves a young male patient with a previous scaphoid non-union even after multiple treatment attempts, illustrating the complexities involved in wrist surgery.
Dr. Tuckman discusses various treatment options, including revision repair, salvage procedures, and the advantages of using an osteoarticular graft over other methods, such as rib grafting or vascularized bone grafts, emphasizing the reduced morbidity and technical simplicity.
The procedure begins with detailed preoperative preparations, including anesthesia and surgical site exposure via a single dorsal incision. The video captures meticulous steps of the operation such as the identification of anatomical structures, dissection, capsulotomy, and the removal of the proximal pole, concluding with the preparation and insertion of the graft.
Dr. Tuckman employs intraoperative fluoroscopy to ensure correct placement and alignment of the graft, followed by secure fixation using headless compression screws. He also covers postoperative management, including the use of a bone stimulator and gradual rehabilitation leading to successful healing of the graft, confirmed by CT scans and x-rays at subsequent follow-ups.
In closing, Dr. Tuckman encourages viewer feedback on the surgical technique demonstrated, inviting engagement and discussion in the medical community.
Part of: Surgical Techniques and Training Collection
"Proximal Hamate to Scaphoid Nonunion Reconstruction" is included in the following Surgical Techniques and Training playlist: