Hemi-hamate autograft for reconstruction of the middle phalanx base

Abstract

Objective To discuss the techniques and treatment outcomes of hemi-hamate autograft for reconstruction of the middle phalanx base.Methods Twelve cases of intra-articular comminuted fractures of middle phalanx base in 12 fingers were treated with transfer of hamate articular surface.Mini screws and external fixator were used to fix the pieces.Restricted functional exercise was carried out in the first 2 postoperative weeks.The external fixator was removed 4 to 6 weeks postoperatively dependent on fracture healing.Active joint movement was gradually increased.Results The patients were follow-up for 6 to 18 months.All the middle phalanx base fractures healed.Joint deformities were corrected.Proximal interphalangeal joint movement was satisfactory.The total range of motion of the finger was 180 °to 260 °.Based on the total active motion evaluation,the results were rated as excellent in 6 fingers,good in 3 fingers,fair in 2 fingers and poor in 1 finger.The excellent and good rate was 75％.Conclusion Hemi-hamate articular surface transfer is a good surgical procedure for treating intra-articular comminuted fractures of middle phalanx base.Early restricted functional exercise is beneficial to the recovery of joint function. Key words: Hamate; Phalanx; Fractures, bone; Fracture fixation