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Takeshi Ogawa, Shunsuke Asakawa
We report two rare cases of existing or worsening symptoms due to Kienböck's disease after distal radius fracture (DRF). During examination, radiographs show changes in the lunate bone; there was persistent wrist pain after treatment for DRF. In each case, surgeries were performed: A combined therapy (bone marrow transfusion, bone peg graft, external fixation, and low intensity pulsed ultrasound) for one, as well as carpal coalition for another. The etiology of these case presentations suggest that a compression fracture of the lunate due to a DRF resulted in softening and sclerosis...
December 2018: Journal of Hand Surgery Asian-Pacific Volume
Hirofusa Ichinose, Ryogo Nakamura, Etsuhiro Nakao, Takaaki Shinohara, Masahiro Tatebe, Harumoto Yamada
Background and Purpose  Wrist swelling is a frequent clinical manifestation of Kienböck's disease, but no study has reported the site and pathology of wrist swelling in this disease. The aim of this study is to elucidate the site and pathology of wrist swelling in Kienböck's disease. Materials and Methods  Dorsal and palmar soft tissue thicknesses of the wrist were measured on standard lateral radiographs of the wrist in 26 patients with Kienböck's disease and 30 subjects without intra-articular lesion...
November 2018: Journal of Wrist Surgery
Paulo Jorge Figueira, Diogo Alpuim Costa, Nunzio Barbagallo, Francisco Gamito Guerreiro
Kienböck's disease is a rare condition characterised by avascular necrosis of the lunate bone. Its natural history and aetiopathogenesis have not yet been clarified, nor are its triggering factors identified. We present a case of a 17-year-old male gymnast, without relevant medical/family history, with stage IIIA Kienböck's disease diagnosed in 2016. Initially, submitted to conservative treatment that proved to be insufficient. Consequently, surgical treatment was proposed, but refused. The patient instead underwent experimental treatment with hyperbaric oxygen (120 sessions, 100% oxygen at 2...
October 12, 2018: BMJ Case Reports
Galal Hegazy, Ahmed Akar, Tharwat Abd-Elghany, Emad Zayed, Elsayed Shaheen, Tarek Mansour
PURPOSE: We evaluated whether a surgical technique combining distal capitate shortening and arthrodesis to the base of the third metacarpal bone for the treatment of the early stages (stages II and IIIA) of Kienböck's disease with neutral ulnar variance resulted in pain relief, improvement in wrist motion, or changes in the radiographic evaluation. METHODS: This retrospective study reviewed 22 patients with early stages of Kienböck's disease with neutral ulnar variance, treated by distal capitate shortening and arthrodesis to the base of the third metacarpal bone...
October 8, 2018: Journal of Hand Surgery
Okan Aslantürk, Kadir Ertem, Emre Ergen, Muhammed Köroğlu
PURPOSE: The aim of this study was to evaluate short-term clinical and radiological results of extensor carpi radialis longus (ECRL) tendon ball arthroplasty for treatment of late-stage Kienböck's disease. METHODS: We retrospectively reviewed data of 19 patients suffering from Kienböck's treated with ECRL tendon ball arthroplasty between December 2014 and December 2016. Patients' clinical functions were assessed using grip strength, range of motion (ROM) of the wrist, QuickDASH, Mayo wrist score, and visual analog scale score...
May 2018: Journal of Orthopaedic Surgery
In-Tae Hong, Soohyun Lee, Gyu Chol Jang, Gotak Kim, Soo-Hong Han
PURPOSE: There are only few studies that focused on Kienböck's disease with non-negative ulnar variance, even though many surgical procedures have been introduced. A combined radial wedge and shortening osteotomy was carried out for Kienböck's disease with non-negative ulnar variance. The purpose of this article is to report the results of this procedure by analyzing the clinical and radiological data. MATERIAL AND METHODS: The data for patients with Kienböck's disease who were treated by combined radial wedge and shortening osteotomy between 2007 and 2016 were retrospectively reviewed...
September 19, 2018: Der Orthopäde
Akihiro Hirakawa, Shingo Komura, Haruhiko Akiyama
No abstract text is available yet for this article.
August 20, 2018: Hand: Official Journal of the American Association for Hand Surgery
Young Ho Shin, Jae Kwang Kim, Minkyu Han, Tae Kyoon Lee, Jun O Yoon
BACKGROUND: Radial osteotomy has shown favorable clinical results for early to advanced stages of Kienböck disease. However, it is not clear whether this technique could change the natural course of the disease, or whether its clinical results are actually superior to those of nonoperative treatment. The purpose of this study was to compare radial osteotomy with nonoperative treatment in terms of long-term radiographic and clinical outcomes in patients with Kienböck disease. METHODS: We systematically reviewed retrospective studies of radial osteotomy and nonoperative treatment for Kienböck disease with long-term follow-up (mean of ≥10 years)...
July 18, 2018: Journal of Bone and Joint Surgery. American Volume
Muhammed Yesiloz, Matthias Louis, Jacques DeVerbizier, Gilles Dautel, François Dap, Alain Blum, Pedro Gondim Teixeira
The management of Kienböck's disease is complex and constantly evolving in parallel with progress in the understanding of the pathophysiological mechanisms of this condition. Cross-sectional imaging techniques have an essential role in the diagnosis and prognostic assessment of this disease. CT allows the optimal study of the morpho-structure of lunate bone. MRI makes it possible to study bone marrow viability. As for CT arthrography, it allows to evaluate accurately articular cartilage of the different carpal joints...
August 2018: European Journal of Radiology
Justin Chou, Guillaume Bacle, Eugene T H Ek, Stephen K Y Tham
PURPOSE: To describe an uncommon subset of fractured lunates in Kienböck disease that is salvageable by internal fixation. METHODS: We performed a retrospective review for patients with Kienböck disease treated by internal fixation. Demographic data, objective and radiographic measurements, patient-reported outcome measures (Disabilities of the Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation) and pain (visual analog scale) scores were collected. RESULTS: Of the 7 patients treated, 5 were available for review...
June 19, 2018: Journal of Hand Surgery
Joshua A Gillis, James P Higgins
CASE: We describe a patient with Bain grade-2b Kienböck disease with a coronal fracture of the distal lunate articular surface with proximal structure collapse. To reestablish midcarpal congruity, we used a bone-anchored suture to repair the coronal split in the lunate in preparation for lunate preservation with osteochondral medial femoral trochlea (MFT) reconstruction. CONCLUSION: In Bain grade-2b Kienböck disease, lunate reconstruction of both the proximal and distal joint surfaces can be performed...
April 2018: JBJS Case Connector
Sergi Barrera-Ochoa, David Campillo-Recio, Tryno Muñoz-Perdomo, Ignacio Esteban-Feliu, Gerardo Mendez-Sanchez, Xavier Mir-Bullo
The treatment of advanced-stage Kienböck disease (KD) remains highly controversial. Particularly important is stage IIIC KD, which includes patients with a lunate coronal fracture. The purpose of this paper was to describe a new approach to KD in patients with Lichtman stage IIIC KD, and our results using it. The procedure combines a dorsolateral biplane closing radial osteotomy and lunate fixation. A total of 11 patients from January 2002 through December 2016 with documented KD who underwent this technique were included...
September 2018: Techniques in Hand & Upper Extremity Surgery
Jianbing Li, Zhijun Pan, Yunzhen Zhao, Xinlei Hu, Xiang Zhao
The aim of this study was to assess the results of capitate osteotomy and transposition for stage III Kienböck's disease. Capitate osteotomy and transposition combined with an autologous iliac bone graft was carried out in 17 patients. At the final follow-up for a mean of 68 months (range 16-127 months) after surgery, the mean visual analogue scale score was 0.6 (range 0-5). The mean Wrightington wrist function score was 8. The mean grip strength was 79% of the unaffected side. There were 16 satisfactory results...
September 2018: Journal of Hand Surgery, European Volume
Timo Viljakka, Kaj Tallroth, Martti Vastamäki
PURPOSE: Titanium lunate arthroplasty (TLA) for Kienböck disease was introduced in 1984 to address the silicone-wear particle problem common to silicone lunate implants. We sought to study the outcome of TLA. METHODS: We identified 11 patients from our hospital database who had undergone TLA between 2001 and 2010. We evaluated pain, range of motion (ROM), function, and radiological outcome at a mean 11 years after surgery. We compared preoperative ROM and radiological findings with final follow-up in the ipsilateral wrist and also made comparisons with the contralateral wrists...
October 2018: Journal of Hand Surgery
T Lögters, C Büren, J Windolf
Kienböck's disease, also known as avascular necrosis of the lunate bone describes the slowly progressive osteonecrosis of the lunate bone with secondary development of osteoarthritis and carpal collapse. In order to emphasize the atraumatic origin of the disease, this is normally referred to as aseptic, idiopathic or avascular lunate necrosis. There are thought to be a number of factors predisposing to Kienböck's disease, such as ulnar negative variance, the shape of the lunate itself and various types of vascular anatomy...
May 2018: Der Unfallchirurg
Schneider K Rancy, Eugene T Ek, Sophia Paul, Robert N Hotchkiss, Scott W Wolfe
Purpose  This study aims to compare the outcomes and complications of our technique for nonspanning total wrist arthrodesis using a locking plate with the standard carpometacarpal spanning technique. Methods  A retrospective review of charts was performed to identify patients who underwent total wrist arthrodesis by the senior author (S.W.W.). We compared the outcomes of 15 cases of nonspanning wrist fusion with a 2.4/2.7 mm locking T plate to 11 cases of spanning wrist fusion with a 2.7/3.5 mm locking compression plate...
April 2018: Journal of Wrist Surgery
Ahmadreza Afshar
Kienböck disease is uncommon in skeletally immature patients. Although there is no gold standard treatment for Kienböck disease in the skeletally immature patient, surgical and nonsurgical treatment options have been shown to be effective. Initial immobilization with a cast, protection with an orthosis, and avoidance of repetitive forceful activities have been shown to be effective in some cases. Surgery may be offered to the skeletally immature patient when nonsurgical treatment is ineffective. Among several surgical techniques used for treatment in the skeletally immature patient with Kienböck disease, distal radial osteotomies have been the most frequently performed surgery; however, radial overgrowth is a concern...
May 2018: Journal of Hand Surgery
Hammad Parwaiz, Sherif Elnikety
Kienböck's disease is characterised by avascular necrosis of the lunate bone, and over the years it has been a challenging disease to manage, with differing opinions on the best intervention. We present an interesting case of a metallic unconstrained lunate replacement that is still functioning well in a patient 40 years after surgery. This case report represents the longest follow-up of any such prosthesis.
March 15, 2018: BMJ Case Reports
Martín Greco, Juan Carlos Quevedo, Félix Francisco, Sabrina Ghiglione, Tatiana Marrero, Antonio Naranjo
No abstract text is available yet for this article.
March 13, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Mesut Tahta, Cem Ozcan, Gurkan Yildiz, Izge Gunal, Muhittin Sener
OBJECTIVE: The aim of this study was to report our results of lunate excision combined with capitohamate fusion in the treatment of Kienböck's stage IIIB/IIIC disease. METHODS: A total of 7 patients with a mean age 35.2 (SD 11.5) years were enrolled in the study. Pain was the principal reason for surgery. All operations were carried out by the same senior surgeon. Patients were evaluated in terms of range of motion, DASH and VAS scores, satisfaction, and grip/tip/palmar/key pinch strength compared with contralateral sides...
May 2018: Acta Orthopaedica et Traumatologica Turcica
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