chapter  16
8 Pages

Prosthetic Arthroplasty of Proximal Pole Scaphoid Nonunions

Pseudarthrosis and necrosis of the proximal pole of the

scaphoid are difficult to treat and the outcome is uncertain,

particularly in elderly people. Eventually, this problem leads to

radioscaphoid arthritis, which progressively spreads to the

entire wrist and causes carpal collapse, in a typical pattern:

scaphoid nonunion advanced collapse (wrist). In the same way,

scapholunate dislocation rapidly leads to styloscaphoid

arthritis in which the capitate collapses into the scapholunate

space: scapholunate advanced collapse (wrist). Several authors

have previously advocated the replacement of the proximal

pole of the scaphoid. The silicon spacer promoted byMichon (1)

then by Zemel (2) is no longer used and has been replaced by

autologous biological materials proposed by Eaton (3). Jones (4)

proposed a spherical vitallium implant, whereby the prosthesis

was put into a cage with the risk of dislocation.