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
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.
http://www.medmedia.com/a7/110.htm
Good results in 8 cases followed for 3 years.
Acta Orthopaedica Scandinavica. [JC:1go] 63(5):560-2, 1992 Oct. 8 patients with Kienbock's disease and without negative ulnar variance were treated with a modification of Chuinard's capitate-hamate fusion. All patients returned to their normal activities free of pain. The postoperative wrist motion was unchanged, but the grip strength was increased.