PMC7439174_01
Plain X-ray findings show sharpening of the styloid process, narrowing between the radial scaphoid bones, and growth of the dorsal ridge.
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Plain X-rays revealed advanced stage SNAC in the left hand; supinated oblique view revealed an enlarged soft tissue shadow due to the growth of the dorsal ridge (Figure 1).
A cartilage defect is observed in the capitate bone (arrow). A proximal-type scaphoid pseudarthrosis with bony growth into the dorsal ridge is observed (oval).
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A proximal-type scaphoid nonunion was detected, and bone growth to the dorsal part of the dorsal ridge was observed (Figure 2).
X-ray image obtained immediately after the surgery using the Watson method.
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We performed scaphoid lunate advanced collapse (SLAC) reconstruction using a 4-corner fusion procedure described by Watson and Ballet, replacing the missing EPL tendon with the extensor indicis proprius (EIP) tendon using Pulvertaft weave fashion (Figure 3).
Postoperative macroscopic findings. Improvements in the EPL tendon could not be confirmed, and the transferred tendon is not palpable in the snuff box (arrow).
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The patient was unable to extend his thumb, improvement in the transferred tendon function could not be confirmed, and the transferred tendon was not palpable in the snuff box (Figure 4).
Macroscopic findings at the time of the second surgery. EPL tendon rerupture is shown to have occurred in the dead space where the scaphoid bone was previously located.
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The transferred EIP tendon had reruptured in the dead space where the scaphoid bone was previously located (Figure 5).