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Autologous Osteoligamentous Reconstruction of Scaphoid Proximal Pole With Metatarsal Head and Collateral Ligament: Cadaver Anatomic Description of Novel Surgical Technique.

Publication ,  Journal Article
Larkins, CG; Tannan, SC; Burkett, AE; Mithani, SK; Srinivasan, RC; Pederson, WC
Published in: Hand (N Y)
November 2021

Background: Historically, scaphoid nonunion has been surgically treated with vascularized bone graft taken from multiple different anatomic sites. However, none of these grafts fully recapitulate the unique osteoligamentous anatomy of the proximal pole of the scaphoid and the attachment of the scapholunate ligament (SLIL). We studied the anatomy of the vascularized second metatarsal head with its lateral collateral ligament as a potential novel treatment of proximal pole scaphoid nonunion with collapse. Methods: Scaphoids and second metatarsal heads were harvested from bilateral upper and lower extremities of 18 fresh frozen cadavers (10 male, 8 female) for a total of 36 scaphoids and 36 second metatarsal heads. The ipsilateral second metatarsal head was harvested with its lateral collateral ligament and its blood supply from the second dorsal metatarsal artery (SDMA). Measurements of the scaphoid, the SLIL, the second metatarsal head, and lateral collateral ligaments were compared to matched limbs from the same cadaver. Results: The anatomic dimensions of the second metatarsal head with its lateral collateral ligament are similar to the scaphoid proximal pole and the SLIL in matched cadaveric specimen. Conclusions: This anatomic cadaver study reveals that the second metatarsal head with its associated lateral collateral ligament is a well-matched donor to reconstruct the proximal pole of the scaphoid and SLIL. This anatomic similarity may be well suited to treat nonunion of the scaphoid proximal pole with or without avascular necrosis with simultaneous reconstruction of the SLIL. The authors describe a technique of vascularized reconstruction of the osteoligamentous proximal pole of the scaphoid with its attached SLIL utilizing autologous second metatarsal head with its attached lateral collateral ligament. Based on this cadaver study, this technique merits consideration.

Duke Scholars

Published In

Hand (N Y)

DOI

EISSN

1558-9455

Publication Date

November 2021

Volume

16

Issue

6

Start / End Page

843 / 846

Location

United States

Related Subject Headings

  • Wrist Joint
  • Scaphoid Bone
  • Orthopedics
  • Metatarsal Bones
  • Male
  • Humans
  • Female
  • Collateral Ligaments
  • Cadaver
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Larkins, C. G., Tannan, S. C., Burkett, A. E., Mithani, S. K., Srinivasan, R. C., & Pederson, W. C. (2021). Autologous Osteoligamentous Reconstruction of Scaphoid Proximal Pole With Metatarsal Head and Collateral Ligament: Cadaver Anatomic Description of Novel Surgical Technique. Hand (N Y), 16(6), 843–846. https://doi.org/10.1177/1558944719895616
Larkins, Christopher G., Shruti C. Tannan, Alison E. Burkett, Suhail K. Mithani, Ramesh C. Srinivasan, and William C. Pederson. “Autologous Osteoligamentous Reconstruction of Scaphoid Proximal Pole With Metatarsal Head and Collateral Ligament: Cadaver Anatomic Description of Novel Surgical Technique.Hand (N Y) 16, no. 6 (November 2021): 843–46. https://doi.org/10.1177/1558944719895616.
Larkins, Christopher G., et al. “Autologous Osteoligamentous Reconstruction of Scaphoid Proximal Pole With Metatarsal Head and Collateral Ligament: Cadaver Anatomic Description of Novel Surgical Technique.Hand (N Y), vol. 16, no. 6, Nov. 2021, pp. 843–46. Pubmed, doi:10.1177/1558944719895616.
Journal cover image

Published In

Hand (N Y)

DOI

EISSN

1558-9455

Publication Date

November 2021

Volume

16

Issue

6

Start / End Page

843 / 846

Location

United States

Related Subject Headings

  • Wrist Joint
  • Scaphoid Bone
  • Orthopedics
  • Metatarsal Bones
  • Male
  • Humans
  • Female
  • Collateral Ligaments
  • Cadaver
  • 3202 Clinical sciences