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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.