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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...
March 2, 2018: Acta Orthopaedica et Traumatologica Turcica
Taiichi Matsumoto, Ryosuke Kakinoki, Ryosuke Ikeguchi, Souichi Ohta, Masao Akagi, Shuichi Matsuda
PURPOSE: To report the outcomes of patients with stage III Kienböck disease treated by vascularized bone graft (VBG) followed by temporary scaphocapitate (SC) fixation, a minimum of 2 years after surgery. METHODS: Twenty-six patients (mean age, 35 years) with stage III Kienböck disease (16 with stage IIIA and 10 with stage IIIB), treated with VBG followed by SC fixation for 4 months, were retrospectively followed for at least 2 years (range, 24-121 months; mean, 61...
February 14, 2018: Journal of Hand Surgery
Montserrat Ocampos Hernandez, Fernando Corella Montoya, Miguel Del Cerro Gutierrez, Ricardo Larrainzar Garijo
Proximal row carpectomy (PRC) is a well-accepted procedure for the treatment of degenerative lesions of the wrist and advance Kienböck disease. This procedure has been classically described as an open procedure but recently has been reported as an arthroscopic one. Arthroscopic PRC has several advantages such as minimal damage to the dorsal and volar ligaments as well as there being no need to detach the capsule, which can facilitate earlier mobilization and can decrease postoperative stiffness. In addition, there is a reduced risk of the interosseous posterior nerve being injured, and the proprioception system continues to function...
August 2017: Arthroscopy Techniques
Yuji Tomori, Takuya Sawaizumi, Nanno Mitsuhiko, Shinro Takai
RATIONALE: Idiopathic avascular necrosis of the scaphoid or lunate bone are known as Preiser disease and Kienböck disease, respectively. Although there are reports of avascular necrosis involving more than one carpal bone, concurrent idiopathic avascular necrosis of the scaphoid and lunate bones is rare, with only five cases reported in the English literature (including the two herein). Although the optimum treatment for Preiser disease with concomitant Kienböck disease has not been established, our cases underwent closed radial wedge osteotomy based on the evidence of satisfactory outcomes for treating Kienböck disease...
December 2017: Medicine (Baltimore)
Elissa S Finkler, Terry R Light
CASE: We describe the case of a 40-year-old man with Minnaar type-III congenital synostosis of the lunate and the triquetrum who presented with Lichtman stage-I Kienböck disease. Surgical treatment consisted of capitate shortening with a capitate-hamate fusion. CONCLUSION: This case demonstrates the tenuous regional nature of the vascularity to the lunate, even in the setting of a complete lunotriquetral synostosis.
April 2017: JBJS Case Connector
Mei-Ming Xie, Kang-Lai Tang, Chen-Song Yuan
Stage IIIc Kienböck's disease is a clinical challenge to treat collapse of the lunate bone. A new reconstructive surgery was described in one patient using 3D printing lunate prosthesis. The prosthesis shape was designed by tomographic image processing and segmentation using technology compared with the intact side matched by mirror symmetry and 3D post-processing technologies. The patient recovered nearly full range of motion of the wrist after 12 months. The visual analog scale scores and Cooney scores were 2 points and 91 points...
April 2018: Archives of Orthopaedic and Trauma Surgery
Hirotaka Okubo, Chojo Futenma, Hideyuki Sunagawa, Masaki Kinjo, Fuminori Kanaya
BACKGROUND: Radius osteotomy is one of the standard surgical procedures for the treatment of Kienböck's disease. Unfortunately, radius osteotomy can result in an incongruous distal radio-ulnar joint (DRUj) postoperatively, because the procedure is performed proximal to the DRUj. METHODS: A very distal radius wedge osteotomy was performed as a 15-degree lateral closing wedge osteotomy with the apex of the wedge distal to that of conventional lateral closing wedge osteotomy; this procedure was developed to avoid postoperative incongruous DRUj...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
Amaury Charre, Stephanie Delclaux, Costel Apredoai, Jean-Emmanuel Ayel, Michel Rongieres, Pierre Mansat
Scaphocapitate arthrodesis with lunate excision was performed for treatment of advanced Kienböck disease in 17 patients (18 wrists). Ten were women and seven men. Five were Lichtmann Stage IIIA, 12 Stage IIIB, and one Stage IV. Minimum follow-up period was 24 months; mean follow-up was 10.7 years (range 2.3 to 22 years, SD 7.1). At the latest follow-up, six patients were very satisfied, nine were satisfied and two were disappointed. Pain was significantly decreased in all cases. Wrist mobility was unchanged...
January 1, 2017: Journal of Hand Surgery, European Volume
Wouter F van Leeuwen, Stein J Janssen, Thierry G Guitton, Neal Chen, David Ring
BACKGROUND: The appearance of early Kienböck disease on radiographs and magnetic resonance imaging (MRI) may be difficult to distinguish from other conditions that affect the lunate. We aimed to assess the interobserver agreement in the diagnosis of early Kienböck disease when evaluated on different imaging modalities. METHODS: Forty-three hand surgeon members of the Science of Variation Group were randomized to evaluate radiographs and 35 hand surgeons to evaluate radiographs and MRI scans of 26 patients for the presence of Kienböck disease, the lunate type, and the ulnar variance...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
Francesco Giacalone, Pietro G di Summa, Alessandro Fenoglio, Arman Sard, Elisa Dutto, Matteo Ferrero, Maddalena Bertolini, Marc Garcia-Elias
BACKGROUND: The Resurfacing Capitate Pyrocarbon Implant associated with proximal row carpectomy has been used to treat symptomatic advanced carpal collapse, widening the indications of proximal row carpectomy to patients with capitate head arthritis. The authors retrospectively compared their case series of implant versus carpectomy alone, analyzing whether prosthetic implant outcomes could be similar to those of proximal row carpectomy even with a higher stage of osteoarthritis. METHODS: Fifty-seven patients who underwent surgery for wrist osteoarthritis (minimum follow-up, 2 years) were selected retrospectively...
November 2017: Plastic and Reconstructive Surgery
Hui Lu, Qiang Chen, Hang Yu, Zhenfeng Liu
Cases of Kienböck's disease combined with gout are rare; to the best of our knowledge, the current report is the third such case reported in the literature. The current report presents the case of a 49-year-old male patient with Kienböck's disease combined with gout. The patient had experienced swelling and pain of their right wrist for 1 month. Through a combination of clinical history, physical examination, laboratory results, radiological and intraoperative findings, the patient was diagnosed with stage IIIB-IV Kienböck's disease and gout...
November 2017: Experimental and Therapeutic Medicine
Simon B M MacLean, Karim Kantar, Gregory I Bain, David M Lichtman
Kienbock disease (KD) is a disease of uncertain etiology, leading to chondral and osseous change in the lunate and wrist. Traditionally, Lichtman's classification of KD, based on radiographic appearances, has been used to direct treatment. Diagnostic wrist arthroscopy allows direct assessment of the lunate and surrounding articulations. Wrist arthroscopy can also serve as a therapeutic tool for performing debridement, resection, or arthrodesis procedures. The new Lichtman-Bain algorithm takes into consideration the status of the lunate, the effect on the wrist, and surgical and patient factors to guide management...
November 2017: Hand Clinics
Wouter F van Leeuwen, Matthew A Tarabochia, Arnold H Schuurman, Neal Chen, David Ring
PURPOSE: Not all patients with Kienböck disease progress to collapse of the lunate and carpal malalignment, but it is difficult to determine which patients are at risk. We aimed to identify demographic or anatomical factors associated with more advanced stages of Kienböck disease. METHODS: We included all 195 eligible patients with Kienböck disease and available preoperative posteroanterior and lateral radiographs. We compared the mean age, sex distribution, mean ulnar variance, radial height, radial (ulnarward) inclination, palmar tilt, anteroposterior distance, and lunate type among the different Lichtman stages of Kienböck disease and performed ordinal logistic regression analysis...
November 2017: Journal of Hand Surgery
Zi-Run Xiao, Wei-Guang Zhang, Ge Xiong, You-Le Zhang
BACKGROUND: The etiology of Kienböck's disease is controversial, and the blood supply is a possible pathogenic factor. The red lead (Pb3O4) angiography with micro-computed tomography (micro-CT) of lunate to investigate intralunate arteries has rarely been reported. This study aimed to investigate a new, reasonable, and simplified technique to study the intraosseous arterial pattern of normal lunates. METHODS: This study investigated the intraosseous arterial pattern of six normal cadaveric lunates through Pb3O4injection and three-dimensional reconstruction with micro-CT...
November 5, 2017: Chinese Medical Journal
Young Ho Shin, Jihyeung Kim, Hyun Sik Gong, Seung Hwan Rhee, Min Joon Cho, Goo Hyun Baek
BACKGROUND: Radius osteotomies showed favorable clinical outcome in Kienböck's disease. However, few articles have been published on the long-term outcome of lateral wedge osteotomy of the radius in patients with advanced stage Kienböck's disease. METHODS: Eleven patients with Lichtman stage IIIB/IV Kienböck's disease (group A; mean follow-up period, 86.1 months; range, 48 to 163 months) and 14 patients with Lichtman stage IIIA Kienböck's disease (group B; mean follow-up period, 85...
September 2017: Clinics in Orthopedic Surgery
A Barbati, A Geraci, M Borri, F Polidoro, S Di Carlo, V Salini
Spontaneous rupture of the digital extensor tendons of the hand has been reported after Kienbocks disease, rheumatoid arthritis, Vaughan-Jackson syndrome, distal radial fracture. Rupture may also occur as a consequence of unrecognized carpal lunate fracture. We present a case report of a man affected with spontaneous rupture of the digital extensor tendons secondary to unrecognized carpal lunate fracture with partial dorsal dislocation. The edges of the tendon were debrided and sutured using a locked modified Kessler suture...
March 2017: Acta Ortopédica Mexicana
Jorge G Boretto, David Fernandez-Fernandez, Gerardo Gallucci, Pablo De Carli
BACKGROUND: Carpometacarpal joints can be affected by traumatic or degenerative pathology. Although different techniques have been described to treat these conditions, most authors agree that arthrodesis is an effective treatment modality. Vascularized bone grafts of the distal radius have been used to treat carpal conditions, such as scaphoid nonunion or Kiënbock disease, and they have been shown to have several advantages over nonvascularized bone grafts. METHODS: We report a case of a carpal boss in a female patient treated with an arthrodesis of the second and third carpometacarpal joints by using the fourth extensor compartment artery vascularized bone graft...
September 2017: Hand: Official Journal of the American Association for Hand Surgery
B Chedal-Bornu, D Corcella, A Forli, F Moutet, M Bouyer
The aim of this study was to determine and analyze the functional and radiographic outcomes after proximal row carpectomy (PRC). We hypothesized that this surgery could restore wrist mobility and function in case of radiocarpal osteoarthritis or severe carpal trauma. Sixty-two patients who had undergone PRC were included in this study: 44 patients with wrist osteoarthritis (11 SNAC, 24 SLAC, 3 Kienböck's disease, 6 other) and 18 patients with severe carpal trauma. Each patient underwent clinical (pain, range of motion, grip strength, functional scores) and radiographic evaluations...
October 2017: Hand Surgery and Rehabilitation
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