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Avascular necrosis lunate

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https://www.readbyqxmd.com/read/29310416/medium-term-outcome-of-closed-radial-wedge-osteotomy-of-the-distal-radius-for-preiser-disease-with-concomitant-kienb%C3%A3-ck-disease-two-case-reports-and-a-literature-review
#1
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)
https://www.readbyqxmd.com/read/29282524/perilunate-fracture-dislocations-clinical-and-radiological-results-of-21-cases
#2
Thomas Meszaros, Esther Vögelin, Lukas Mathys, Franck Marie Leclère
BACKGROUND: Perilunate dislocations and fracture-dislocations are a subcategory of the carpal instability complex. Herein, we report our university hospital experience with this complex injury. The goal of our study was to find predictive factors and quantify the development of arthritis and lunate necrosis. We tried to measure the impact of arthritis on hand function. METHODS: Between January 2000 and December 2014, 21 patients underwent surgery for perilunate dislocations and perilunate fracture-dislocations of the wrist in our tertiary university center...
December 27, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28971058/ultrasonography-detected-missed-lunate-volar-dislocation-associated-with-median-neuropathy-a-case-report
#3
Kyeongwon Kim, Min-Wook Kim
Lunate and perilunate dislocations are uncommon, but they have clinical importance because complications, such as median neuropathy and avascular necrosis of the lunate, can occur. Although early diagnosis enabling early surgical treatment is crucial for preventing long-term sequelae, these dislocations are frequently missed in the initial assessment. Imaging tools, such as plain radiography, magnetic resonance imaging, ultrasonography, and electrodiagnostic studies, have been used for diagnosis. The proper choice of initial evaluation tools is important for making an accurate early diagnosis...
August 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28969226/perilunate-dislocation-case-report-and-review-of-literature
#4
Karthik Subramanian, Bakul Arora, Abhinav Bhatnagar, Imran Jan
Perilunate dislocations are rare injuries comprising of less than 10% of all wrist injuries. These usually occur after high-energy trauma to the wrist. One-fourth (25%) of perilunate dislocations are missed at the initial presentation. We report a case of perilunate dislocation in a patient who presented late, about two months after trauma. He underwent open reduction through a single dorsal approach and internal fixation with K-wires. Aggressive physiotherapy exercises were started after removal of K-wires...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28765988/scaphoid-nonunion-does-open-reduction-bone-grafting-and-herbert-screw-fixation-justify-the-treatment
#5
K C Kapil Mani, Parimal Acharya
PURPOSE: Conventional bone grafting and Herbert screw fixation give satisfactory results for scaphoid nonunion; however, vascularized bone grafting has superior results, especially in the case of avascular necrosis of proximal fragment. Vascularized bone grafting is technically more demanding with small error of margin, problems of getting the appropriate graft, fixation and incorporation, and requires longer duration for wrist immobilization. METHODS: Forty-five patients of scaphoid nonunion were treated by cancellous bone grafting, cortex containing graft if required and Herbert screw fixation...
August 1, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28626591/a-case-of-trapezium-avascular-necrosis-treated-conservatively
#6
Evangelos Petsatodis, Konstantinos Ditsios, Panagiotis Konstantinou, Iosafat Pinto, Lazaros Kostretzis, Ioannis Theodoroudis, Mayia Pilavaki
INTRODUCTION: Avascular necrosis (AVN) of the bones of the wrist most commonly involves the lunate followed by the proximal pole of the scaphoid and the capitate. Trapezium avascular necrosis is extremely rare with only two cases reported in the literature, both of which were treated surgically. In this article, we report a unique case of trapezium avascular necrosis treated conservatively. CASE PRESENTATION: A 38-year-old man complaining of a 4-month history of mild pain on the base of his right thumb...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28619441/radiologic-guide-to-surgical-treatment-of-kienbock-s-disease
#7
REVIEW
Erika M Nealey, Jonelle M Petscavage-Thomas, Felix S Chew, Christopher H Allan, Alice S Ha
Kienbock's disease, or avascular necrosis of the lunate, is a progressive disease ultimately resulting in end-stage arthrosis of the wrist. Various surgical treatments are available for different Lichtman stages of disease. We review the surgical options and indications, expected radiologic post-operative appearance, as well as detail potential surgical complications, as they relate to Kienbock's disease.
April 25, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28495027/medial-femoral-condyle-microvascular-bone-transfer-as-a-treatment-for-capitate-avascular-necrosis-surgical-technique-and-case-report
#8
Nikolas H Kazmers, Joshua C Rozell, Kevin M Rumball, Scott H Kozin, Dan A Zlotolow, L Scott Levin
Avascular necrosis (AVN) of the capitate is a rare clinical entity for which a variety of treatment options have been described, ranging from immobilization to microvascular bone transfer. Outcomes following medial femoral condyle corticocancellous free flap reconstruction have not been reported for this specific pathology. We present the case of a 16-year-old girl with posttraumatic capitate AVN who was treated with curettage and medial femoral condyle corticocancellous vascularized bone grafting. At 18 months after surgery, the patient remains pain-free and had resumed all activities including lifeguarding by 6 months after surgery...
October 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28453342/flexor-tendon-rupture-due-to-previously-undiagnosed-kienb%C3%A3-ck-disease-a-case-report
#9
Kenrick Turner, Nicholas N Sheppard, Samuel E Norton
BACKGROUND: Spontaneous flexor tendon rupture is rare and most common in the little finger. The pathogenesis of spontaneous tendon ruptures is unclear but may occur through attrition or mechanical abrasion over a bony prominence. Kienböck disease is avascular necrosis of the lunate, with an unknown etiology. METHODS: We present a case of spontaneous rupture of flexor digitorum profundus due to Kienböck disease, which we believe is the first recorded case of flexor tendon rupture attributable to osteonecrosis of the lunate...
May 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28383357/radiopaque-element-to-evaluate-adequacy-of-debridement-of-bony-lesions
#10
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...
September 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28340661/medial-femoral-trochlea-osteochondral-flap-applications-for-scaphoid-and-lunate-reconstruction
#11
REVIEW
James P Higgins, Heinz K Bürger
Vascularized osteochondral flaps are a new technique described for the reconstruction of challenging articular defects of the carpus. The medial femoral trochlea osteochondral flap is supplied by the descending geniculate artery. This osteochondral flap has shown promise in the treatment of recalcitrant scaphoid proximal pole nonunions and advanced avascular necrosis of the lunate. The anatomy, surgical technique, and results are discussed, with clinical cases provided.
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28275828/percutaneous-cementoplasty-for-kienbock-s-disease
#12
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...
May 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28261373/simultaneous-avascular-necrosis-of-the-lunate-and-scaphoid
#13
Benson J Pulikkottil, Edward Ruane, Michael E Scott, Alexandre Philipp Sater, Joseph E Imbriglia
No abstract text is available yet for this article.
2017: Eplasty
https://www.readbyqxmd.com/read/28259113/surgeon-based-3d-printing-for-microvascular-bone-flaps
#14
Erin M Taylor, Matthew L Iorio
Background Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models...
July 2017: Journal of Reconstructive Microsurgery
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
#15
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/28119790/kienb%C3%A3-ck-disease-a-new-algorithm-for-the-21st-century
#16
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/27782999/a-three-dimensional-micro-computed-tomographic-study-of-the-intraosseous-lunate-vasculature-implications-for-surgical-intervention-and-the-development-of-avascular-necrosis
#17
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/27781983/idiopathic-bilateral-lunate-and-triquetrum-avascular-necrosis-a-case-report
#18
L Amsallem, J Serane, D Zbili, B Marion, P Boyer
We report on the case of bilateral avascular osteonecrosis (AVN) of the lunate and triquetrum in a 45-year-old woman without any relevant medical history for which the cause could not be established. She was treated conservatively with splinting and analgesics. The patient was able to pursue her work and hobbies with subnormal range of motion at 1-year follow-up. AVN of the triquetrum is very rare, as it is a richly vascularized bone. The presence of AVN in multiple carpal bones has only been described in patients receiving high doses of corticosteroids...
October 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27777813/the-etiology-and-pathogenesis-of-kienb%C3%A3-ck-disease
#19
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/27524690/kienb%C3%A3-ck-disease-and-carpal-coalitions-a%C3%A2-potential-correlation
#20
Alicia Cowan, Joao Panattoni
Kienböck disease, or lunate avascular necrosis, can lead to chronic wrist pain and instability. Its etiology appears to be multifactorial including variations in adjacent anatomical structures, interrupted blood supply, and trauma. Capitate-hamate fusion is the second most commonly diagnosed carpal coalition and not treated unless symptomatic. Coalitions may alter the wrist mechanics depending on their extent. No prior reports have associated Kienböck disease with capitate-hamate coalition. We present 2 cases with congenital capitate-hamate fusion and lunate AVN...
October 2016: Journal of Hand Surgery
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