Name: Scaphoid Excision and Arthrodesis With DynaNite® Staples, ArthroFLEX® Acellular Dermal Matrix, and ArthroCell™ Viable Cellular Bone Graft
Uploaded: 2020-12-28T00:00:00Z
Channel: Arthrex
Description: Barth B. Riedel, MD (Loma Linda, CA), presents a proximal row carpectomy with DynaNite® staples augmented with ArthroCell™ bone graft and ArthroFlex® decellularized dermal allograft.

<p>Barth B. Riedel, MD (Loma Linda, CA), presents a proximal row carpectomy with DynaNite® staples augmented with ArthroCell™ bone graft and ArthroFlex® decellularized dermal allograft.</p>

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VID1-000602-en-US | A | Scaphoid Excision and Arthrodesis With DynaNite® Staples, ArthroFLEX® Acellular Dermal Matrix, and ArthroCell™ Viable Cellular Bone Graft

Barth B. Riedel

Human

Surgeons presenting one or more clinical cases

Chirurg:innen präsentieren einen oder mehrere klinische Fälle

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Case Presentation Videos

Cirurgiões que apresentam um ou mais casos clínicos.

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Cirujanos que presentan uno o más casos clínicos.

Video presentaciones de casos

Scaphoid Excision and Arthrodesis With DynaNite® Staples, ArthroFLEX® Acellular Dermal Matrix, and ArthroCell™ Viable Cellular Bone Graft

I'm Bart Randall from Loma Linda University Medical Center here to talk about scaphoid lunate, advanced collapse and an extra salvage option for treatment. This first case was a 60 year old male that came in with stage three slack wrist. He was on his dominant arm and he very much wanted to keep his range of motion. So plan was to proceed with scaphoid excision and limited wrist arthrodesis with four corner fusion technique with staples. As we started the case, the standard approach was performed. The scaphoid was removed and the four bones of the limited wrist arthrodesis were decorticated, specifically the capitate, lunate, triquetrum and hamate bones. Upon reduction and getting ready to fixate the staples into the capitate and lunate articulation, the lunate fragmented into approximately six fragments, which could not be reconstructed, and it was seen that they were actually dead bone. This was previously not seen on the imaging. This led to options to think about what else could we do to maintain this patient's range of motion without giving him a total wrist arthrodesis into the supply bag we went. We changed gears and proceeded with the proximal row ectomy using ArthroFLEX as a protective covering, as you can see from this image. The wrist was shotgunned open. The bones specifically between the capitate and hamate were decorticated and filled with ArthroCell bone graft to allow for fusion, and then ArthroFLEX was used as a protective covering using Arthrex 2.7mm Corkscrew anchors on the volar surface. Arthroflex was rolled dorsally, and then a nitinol staple was then used to affix it dorsally. As you can see from the final construct, the range of motion is actually fairly good with this patient, and he gets good protective covering in light of a proximal carp ectomy with arthrosis. At approximately the four month follow up, the patient still had some mild pain in the wrist, but improved from pre-op while maintaining approximately 80 degrees flexion extension arc. Thank you.

Scaphoid Excision and Arthrodesis With DynaNite® Staples, ArthroFLEX® Acellular Dermal Matrix, and ArthroCell™ Viable Cellular Bone Graft

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Scaphoid Excision and Arthrodesis With DynaNite® Staples, ArthroFLEX® Acellular Dermal Matrix, and ArthroCell™ Viable Cellular Bone Graft

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ArthroFLEX^® Decellularized Dermal Allograft