The Hip: Preservation, Replacement and Revision

Capitate-Hamate Fusion



- 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.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, April 12, 2012 1:46 pm