New Delhi: A common wrist injury, left untreated and neglected for years, nearly resulted in the permanent loss of movement for a young adult in Delhi, until surgeons intervened with a rare reconstructive procedure, they said, is performed in fewer than 100 cases worldwide.The patient had suffered a fracture of the scaphoid, a small but crucial bone in the wrist that plays a key role in stability and motion. Like many such injuries, it was initially ignored. Over time, and with repeated strain, including gym activity, the condition of the wound worsened.The bone failed to heal, lost its blood supply, and eventually died and fragmented, a condition known as avascular necrosis.By the time the patient sought medical help at Max Super Speciality Hospital, the situation was critical.Conventional surgical options at this stage are limited — either fuse the wrist joint, impacting movement entirely, or remove part of the wrist bones, significantly reducing mobility.“Such cases are rare but challenging. When the bone is fragmented, reconstruction becomes difficult. Typically, we are left with options like fusion or removal of the bone, both of which compromise function,” said Dr Vikas Gupta, hand and wrist surgeon.Instead, the doctors opted for an innovative solution, reconstructing the wrist using the patient’s own bone. Dr Gupta harvested a portion of the hamate — a neighboring wrist bone with a similar shape — and transplanted it into the space left by the damaged scaphoid. Because the graft came from the same wrist, it eliminated the need for a secondary surgical site.Equally critical was the repair of the scapholunate ligament, which stabilises the wrist by connecting key bones. “We addressed both the bone loss and the ligament injury in a single procedure. Restoring stability is just as important as replacing the bone if you want to bring back movement,” Dr Gupta said.The transplanted bone was carefully matched in size and fixed in place with screws, allowing it to integrate naturally. The wrist was immobilised briefly, followed by early rehabilitation.According to the doctors, the results are promising. The patient has begun regaining mobility and grip strength, and imaging suggests the transplanted bone is healing well.“This technique, proximal hamate transfer to reconstruct the scaphoid, is very novel. Globally, there are probably fewer than 100 documented cases. The goal is to restore both mobility and stability, especially in young, active individuals,” the surgeon said while pointing out that the even minor wrist injuries should not be ignored as, if left untended, they can silently progress to severe damage where saving function becomes far more complex.
