Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 25587
COMPLETE ABSENCE OF THE SCAPHOID- A UNIQUE CASE AND ITS
MANAGEMENT
Rahul KAKKAR 1 , F. TEBOUL 2 , C. OBERLIN 2
1 Northern Deanery, Newcastle (UNITED KINGDOM), 2 Hopital Bichat, Paris
(FRANCE)
Complete absence of the scaphoid is rare and when it presents without other
associated anomalies it is extremely uncommon. Only seven cases with complete
absence of scaphoid without associated anomalies or with only minor aberrations in
the development of other bony components like associated radial styloid hypoplasia,
hypertrophic radial styloid, associated dysplastic trapezium have been reported.The
case of a 52 year old female is discussed who presented with clinically significant
pain in the right wrist. Radiographs revealed a complete absence of scaphoid with
the capitate shifted radially and dorsally leading to degenerative arthritis of this radiocapitate
articulation. Functional tolerance in this anomaly is high, but if arthritis
supervenes then surgical options like arthrodesis of the lunate to capitate and
hamate have to be considered. This case and all the other cases of congenital
absence of scaphoid without associated anomalies reported in the literature
represent those rare exceptions where the deformity cannot be classified according
to any particular classification and perhaps remind us that other mechanisms and
sequences of isolated growth suppression, not presently known to us, are possible,
in contrast to the one proposed generally that hypoplasia or aplasia is a continuum of
growth suppression starting from the thumb and progressing proximally.
254