Capitate-Hamate Fusion

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- 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;
    - capitate shortening w/ captiate-hamate fusion:
            - may increase scaphoid loading by 20%;
            - captitate is shortened about 3 mm;
            - proximal pole of hamate is removed to prevent hamate-lunate articulation;

- 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;

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Biomechanical analysis of capitate shortening with captiate hamate fusion in the treatment of Kienbock's disease.
      RW Viola et al.   J. Hand Surg. Vol 23-A. No 3. May 1998. p 395.