Shotgun approach and modifications for a Hemi-Hamate Arthroplasty

Articles in Press

Document Type : TECHNICAL NOTE

Authors

1 Rothman Orthopaedics Florida at AdventHealth

2 Medical Student with Rothman Orthopaedics Florida at AdventHealth

3 Orthopedic Hand & Elbow Surgeon Rothman Orthopaedics Florida at AdventHealth, Orlando, FL

10.22038/abjs.2025.89199.4059

Abstract

Hemi-hamate arthroplasty (HHA) is a promising technique for reconstructing of the proximal interphalangeal joint (PIPJ), particularly in dorsal fracture-dislocations with loss of the volar articular surface of the middle phalanx. These injuries challenge joint stability and functionality. HHA requires a detailed reconstruction using a graft from the hamate bone to restore the volar articular surface and hunge mechanics. The “shotgun” approach allows hyperextension after collateral ligament release, providing direct visualization and precise graft placement while minimizing postoperative stiffness. This technical note details key steps for visualization and access to the fracture site, facilitating precise graft placement to ensure alignment of the articular surface, minimizing the risk of a mechanical block or stiffness postoperatively. By addressing technical precision often overlooked, this guide serves as a practical resource for surgeons managing complex PIPJ injuries requiring anatomical restoration. Hemi-hamate arthroplasty (HHA); Proximal interphalangeal joint (PIPJ); Shotgun approach; Bone graft; Joint stability. Level V.

Keywords

Main Subjects

The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 17 December 2025

Files

History

  • Receive Date: 18 July 2025
  • Revise Date: 23 November 2025
  • Accept Date: 03 November 2025

Share

How to cite

Statistics