Hemi-hamate donor site morbidity and complications: a systematic review

Background The hemi-hamate arthroplasty is utilised for the management of complex fracture-dislocations for injuries of the proximal interphalangeal joints (PIPJ) of the fingers. PIPJ outcomes are well described, including the post-operative range of motion, grip strength and osteochondral graft union. However, there is a paucity of evidence analysing the rate of donor site morbidity and complications. This systematic review aims to present the published morbidity of the donor site for the hemi-hamate arthroplasty. Methods A search was conducted in MEDLINE, Embase, Emcare, CINAHL and ProQuest Nursing and Allied Health databases from their inception which yielded 384 articles to be screened. Pertinent anatomy, harvesting techniques and post-operative donor site care of the hemi-hamate arthroplasty is reviewed. Results One hundred three cases of hemi-hamate arthroplasty were included in this review with seven (6.8%) complications presented, one of which required operative intervention. Conclusion Donor site morbidity resulting from harvesting an osteochondral graft for a hemi-hamate arthroplasty is low. The overall quality of evidence from the studies in this review is low, highlighting the need for further robust prospective trials.