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https://www.readbyqxmd.com/read/28383357/radiopaque-element-to-evaluate-adequacy-of-debridement-of-bony-lesions
#1
Nicholas Pulos, Alexander Y Shin
A technique for using an x-ray detectable radiopaque element from a surgical sponge to assess the adequacy of debridement of carpal bone cysts, Kienböck disease (lunate avascular necrosis), enchondroma of the digits, and scaphoid nonunions is described. The technique is simple to perform, inexpensive, and presents minimal additional risk to the patient. The technique has been used over the past 16 years and has enabled adequate debridement of these hand and wrist maladies by radiographically demonstrating the adequacy of the debridement to be bone grafted...
April 5, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28325423/stage%C3%A2-iv-kienb%C3%A3-ck-s-disease-proximal-row-carpectomy-and-application-of-rcpi-implant
#2
A Marcuzzi, F Colantonio, G Petrella, H Ozben, A Russomando
Kienböck disease is an aseptic osteonecrosis of the lunate, which gradually leads to total carpal collapse. Lichtman's classification relates radiographic evidence of wrist damage to four different stages and supports surgical decision-making. This study pertains to six patients (2 males and 4 females) affected by stage IV Kienböck's disease who underwent proximal row carpectomy and received an RCPI implant. The clinical outcomes consisted of wrist range of motion (ROM), pain on a VAS scale (0-10), the DASH score and the patient's level of satisfaction...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28275828/percutaneous-cementoplasty-for-kienbock-s-disease
#3
Eduardo Crespo Vallejo, Mario Martinez-Galdámez, Ernesto Santos Martin, Arturo Perera de Gregorio, Miriam Gamo Gallego, Angeles Ramirez Escobar
Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock's disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion...
March 8, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28274511/a-clinical-trial-for-kienb%C3%A3-ck-disease-by-cultured-autologous-multipotent-mesenchymal-stromal-cells-augmented-with-vascularized-bone-grafts-a-report-of-five-cases
#4
Ryosuke Ikeguchi, Tomoki Aoyama, Ryosuke Kakinoki, Michiko Ueda, Yasuaki Kasai, Taira Maekawa, Harue Tada, Michio Yamamoto, Shuichi Matsuda, Takashi Nakamura, Junya Toguchida
No abstract text is available yet for this article.
March 5, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28219301/lunatum-excision-and-scaphocapitate-arthrodesis-in-kienb%C3%A3-ck-s-disease
#5
Güzelali Özdemir, Turgut Akgül, Özgür Çiçekli, Barış Yılmaz, Hasan Atbinici, Ferit Yücel
PURPOSE: The aim of this study was to compare functional results before and after lunatum excision and scaphocapitate arthrodesis (SCA) using an angular stable circular plate in patients with Lichtman's stage IIIB Kienböck's disease. METHODS: The study included nine patients (six females and three males) with a mean age of 33.2 ± 11 years (range: 18-54 years). Clinical and radiological assessment before and after surgery included wrist extension and flexion, range of motion and grip strength, visual analogue scale (VAS) score to assess pain, modified Mayo wrist scores, and measurements of the scapholunate (SL) angle and modified carpal height ratio...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28196441/radial-shortening-osteotomy-for-treatment-of-lichtman-stage-iiia-kienb%C3%A3-ck-disease
#6
M Luegmair, F Goehtz, K Kalb, J Cip, J van Schoonhoven
We carried out a retrospective study to analyse the long-term outcome of 36 patients after radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease at a mean follow-up of 12.1 years (range 5.4-17.5). At review, seven wrists had progressed to Stage IIIB, eight wrists to Stage IV and 21 remained in Stage IIIA. Motion and grip strength were significantly improved. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score at review was 12 points (range 0-52), and patient satisfaction was high...
March 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28185993/intracarpal-shortening-osteotomy-for-kienb%C3%A3-ck-s-disease-a-retrospective-study-of-28%C3%A2-cases
#7
J Chevrollier, G Pomares, S Huguet, F Dap, G Dautel
INTRODUCTION: Kienböck's disease is rare in patients with a neutral or positive ulnar variance. In these situations, treatment is challenging and controversial. Various intracarpal shortening osteotomy (ICSO) procedures have been proposed. OBJECTIVE: Study the effect of the type of ICSO (isolated capitate osteotomy or combined with hamate osteotomy) on the clinical and radiological outcomes in a retrospective series. METHODS: Patients with Kienböck's disease were treated with ICSO...
April 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28182595/treatment-of-advanced-kienb%C3%A3-ck-disease-with-a-vascularized-radial-bone-flap-wrapped-in-the-pronator-quadratus
#8
Sang Ki Lee, Kap Jung Kim, Hyuck Soo Shin, Won Sik Choy
PURPOSE: In the present study, we aimed to assess the radiologic and clinical outcomes after excision of the lunate, insertion of a vascularized radial bone flap wrapped in the pronator quadratus, and distraction with an external fixator of the joint, for the treatment of avascular necrosis of the lunate with carpal height collapse, fragmentation, and perilunar osteoarthritic changes. MATERIALS AND METHODS: From May 2006 to July 2014, a total of 25 patients (13 men and 12 women; mean age, 38...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28125939/radiological-characteristics-of-kienb%C3%A3-ck-s-disease-in-the-korean-population
#9
Sang Ho Kwak, Ki Ho Lee, Seung-Baik Kang, Hyuk Jin Lee, Goo Hyun Baek
PURPOSE: In Kienböck's disease, the wrist displays certain characteristic radiological parameters, which have been reported to differ among countries. In the present study, we aimed to identify specific radiological parameters of the unaffected wrists in patients with unilateral Kienböck's disease and to determine the extent of the association of each parameter with the disease in Korea. METHODS: This retrospective case-control study assessed the radiological parameters of patients with Kienböck's disease ( n = 53) and controls ( n = 53), who visited our institution between January 2000 and May 2013...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28119790/kienb%C3%A3-ck-disease-a-new-algorithm-for-the-21st-century
#10
David M Lichtman, William F Pientka, Gregory Ian Bain
Background It has been over 100 years since the initial description of avascular necrosis of the lunate. Over the last two decades, there has been the introduction of advanced information regarding the etiology, natural history, classification, and treatment options for lunate osteonecrosis. There have been new classifications developed based on advanced imaging, perfusion studies of lunate viability, and arthroscopic assessment of the articular cartilage. Purpose This article brings together a new treatment algorithm, incorporating the traditional osseous classification system (Lichtman) with the perfusion/viability classification (Schmitt) and the articular cartilage classification (Bain)...
February 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27984361/dorsal-distraction-plating-and-lunate-decortication-for-stage-iii-kienb%C3%A3-ck-disease-a-novel-technique
#11
Michael D Wigton, Omar F Nazir, Benjamin R Graves, Peter J Apel, Zhongyu Li
Kienböck disease (KD) is a progressive condition and difficult to manage. A number of treatment algorithms exist but there is no clear consensus as to which method produces the best outcome, particularly for Lichtman stage III disease. The majority of the current treatment options for KD emphasize lunate unloading and restoration of biology with bone graft. However, less attention has been given to the protection of the lunate during revascularization process. We report a novel technique of lunate decompression and bone grafting, combined with wrist distraction with or without radial shortening osteotomy via dorsal wrist bridge plating for the treatment of stage II-IIIa/b KD...
March 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27902167/arthroscopic-limited-intercarpal-fusion-without-bone-graft-in-patients-with-kienb%C3%A3-ck-s-disease
#12
Kadir Ertem, Gökay Görmeli, Mustafa Karakaplan, Okan Aslantürk, Yunus Karakoç
OBJECTIVES: This study aims to present our clinical results obtained in arthroscopic limited intercarpal fusion performed without using bone graft in patients with Kienböck's disease. PATIENTS AND METHODS: The study included 11 patients with Kienböck's disease (6 males, 5 females; mean age 28.9 years; range 14 to 51 years) who were performed arthroscopic lunate excision and scaphocapitate fusion between November 2012 and December 2013. Bain and Begg Arthroscopic Classification was used for the staging of Kienböck's disease...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27782999/a-three-dimensional-micro-computed-tomographic-study-of-the-intraosseous-lunate-vasculature-implications-for-surgical-intervention-and-the-development-of-avascular-necrosis
#13
Nick A van Alphen, Mohamed Morsy, Alexis T Laungani, Assaf Kadar, Andrew J Vercnocke, Nirusha Lachman, Erik L Ritman, Steven L Moran
BACKGROUND: The purpose of this study was to use micro-computed tomography to demonstrate the intraosseous vascularity of the lunate within a three-dimensional orientation to identify areas of greatest perfusion and define vascular "safe zones" for surgical intervention. METHODS: Fourteen upper extremities were injected with a lead-based contrast agent. The lunates were harvested and scanned using a micro-computed tomography scanner. The intraosseous vascularity was incorporated into a three-dimensional image...
November 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27779256/erratum-the-etiology-and-pathogenesis-of-kienb%C3%A3-ck-disease
#14
Gregory Ian Bain, Simon Bruce Murdoch MacLean, Chong Jin Yeo, Egon Perilli, David M Lichtman
[This corrects the article DOI: 10.1055/s-0036-1583755.].
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777814/kienb%C3%A3-ck-disease-and-arthroscopy-assessment-classification-and-treatment
#15
Gregory I Bain, Simon B M MacLean, Wing-Lim Tse, Pak-Cheong Ho, David M Lichtman
The assessment and management of Kienböck Disease (KD) has always been a conundrum. The Lichtman classification has traditionally been used to guide treatment based on imaging. Arthroscopy provides a direct visualization of the articular surface, allows probing of the surfaces, and enables minimally invasive techniques to be performed. The Lichtman-Bain classification is a new classification that takes into account the osseous, vascular, and cartilage aspects of the lunate and the secondary effects on the wrist...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27777813/the-etiology-and-pathogenesis-of-kienb%C3%A3-ck-disease
#16
Gregory Ian Bain, Simon Bruce Murdoch MacLean, Chong Jin Yeo, Egon Perilli, David M Lichtman
Kienböck disease is a condition that typically occurs in the "at-risk" patient, in the "at-risk" aspect of the proximal condyle of the "at-risk" lunate. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. We postulate that the stress fracture violates the parallel veins of the venous subarticular plexus-leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow...
November 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/27698645/bilateral-legg-calve-perthes-disease-and-kienbock-s-disease-in-a-child-with-factor-v-leiden-thrombophilia-a-case-report
#17
Heather L Baltzer, Scott Riester, Steven L Moran
Background: The etiology of multifocal osteonecrosis is not definitively known; however, hypercoagulable state is a very plausible cause. Methods: We present an unusual case of a 12-year-old boy with a history of Legg-Calve-Perthes disease presenting with right wrist pain who was subsequently diagnosed with Kienbock's disease. The finding of multifocal osteonecrosis prompted testing for a hypercoagulable state that was positive for Factor V Leiden thrombophilia. A thorough literature review using Medline database was conducted to investigate associations between inherited hypercoagulable states and multifocal osteonecrosis...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/27663052/keyhole-revascularization-for-treatment-of-coronal-plane-fracture-of-the-lunate-in-kienb%C3%A3-ck-disease
#18
REVIEW
Jouni Havulinna, Jarkko Jokihaara, Pasi Paavilainen, Olli V Leppänen
Coronal plane fracture of lunate in Kienböck disease is a challenging problem with no proven treatment. We present a technique for the treatment. A vascularized bone graft from the distal radius employing the fourth and fifth extracompartmental artery pedicles is used as a mechanical support in order to enable fracture union. The technical pearls and pitfalls are described and a clinical case is presented.
November 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27626004/distal-radius-radiographic-indices-and-perilunate-fracture-dislocation
#19
Abolfazl Bagherifard, Davod Jafari, Hassan Keihan Shokouh, Ebrahim Motavallian, Farid Najd Mazhar
BACKGROUND: Distal radius radiographic indices may play a role as risk factors in pathogenesis of Kienbock's disease, scaphoid fracture and nonunion. Perilunate fracture dislocations are devastating wrist injuries, and their relationship and distal radius indices have not been addressed in the literature. OBJECTIVES: The aim of this study was to evaluate the possible role of distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt as risk factors in the perilunate fracture dislocation injury of the wrist...
May 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27583101/kuhlmann-vascularized-bone-grafting-for-treatment-of-kienb%C3%A3-ck-s-disease-a-case-report
#20
Mohamed Ali Sbai, Hichem Msek, Sofien Benzarti, Monia Boussen, Riadh Maalla
Treatment of Kienböck's disease has historically been determined by staging, ulnar variance, and presence or absence of arthritic changes. With the advent of newer techniques of vascularized bone grafting, the status of the cartilage shell of the lunate has become another factor that can influence the procedure performed. The purpose of this article is to describe the technique of Kuhlmann vascularized bone graft for Kienböck's disease. In addition, the indications, contraindications, and outcomes are described...
2016: Pan African Medical Journal
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