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Avascular necrosis lunate

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https://www.readbyqxmd.com/read/28495027/medial-femoral-condyle-microvascular-bone-transfer-as-a-treatment-for-capitate-avascular-necrosis-surgical-technique-and-case-report
#1
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...
May 9, 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
#2
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
#3
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 21, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28340661/medial-femoral-trochlea-osteochondral-flap-applications-for-scaphoid-and-lunate-reconstruction
#4
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
#5
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
#6
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
#7
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...
March 4, 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
#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/28119790/kienb%C3%A3-ck-disease-a-new-algorithm-for-the-21st-century
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27104332/transcapho-perilunate-dislocation-with-palmar-extrusion-of-the-scaphoid-proximal-pole
#14
Augusto Marcuzzi, Massimiliano Leigheb
Perilunate fracture-dislocations usually combine ligament ruptures, bone avulsions, and fractures in different patterns. Rarely a displaced fracture of the scaphoid can coexist with a scapho-lunate dissociation and can result in enucleation of the proximal pole. We report about a case of trans-scaphoid perilunate dislocation with palmar extrusion/enucleation of the scaphoid proximal pole, treated with scaphoid fracture open reduction and internal fixation with screw, scapho-lunate ligament repair with an anchor and vascularization of the scaphoid proximal pole with the 2nd intermetacarpal artery...
2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/26855831/prevent-collapse-and-salvage-failures-of-the-volar-rim-of-the-distal-radius
#15
Jorge L Orbay, Francisco Rubio, Lauren L Vernon
Background Articular fractures of the distal radius may include a small fragment from the volar margin of the lunate fossa: volar marginal fragments (VMFs); these fragments are prone to loss of fixation and avascular necrosis, and often result in wrist subluxation. We present our experience managing acute and delayed VMFs. The first is treated using a hook plate extension to a volar locking plate and the latter using a volar opening wedge osteotomy to redistribute loads on the remaining articular surface...
March 2016: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/26802001/treatments-for-kienb%C3%A3-ck-disease-what-the-radiologist-needs-to-know
#16
REVIEW
Carissa White, Prosper Benhaim, Benjamin Plotkin
The etiology of Kienböck disease, or avascular necrosis of the lunate, is controversial, and there are a myriad of treatments aimed at correcting the various hypothesized pathologies. Interventions to reduce mechanical stress on the lunate have been used for decades, including radial osteotomy with or without radial shortening, ulnar lengthening and metaphyseal core decompression procedures. However, these procedures require preservation of lunate architecture. Newer procedures to revascularize the lunate bone have emerged in the last 10 years, such as pedicled corticoperiosteal vascularized bone grafting...
April 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/26682674/avascular-necrosis-of-lunate-bone-kienbock-disease
#17
Ömer Salt, Mustafa Burak Sayhan
No abstract text is available yet for this article.
June 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26612636/arthroscopic-partial-capitate-resection-for-type%C3%A2-ia%C3%A2-avascular-necrosis-a-short-term-outcome%C3%A2-analysis
#18
Takamasa Shimizu, Shohei Omokawa, Francisco del Piñal, Koji Shigematsu, Hisao Moritomo, Yasuhito Tanaka
PURPOSE: To examine short-term clinical results of arthroscopic partial resection for type Ia avascular necrosis of the capitate. METHODS: Patients who underwent arthroscopic treatment for type 1a avascular necrosis of the capitate with at least 1-year follow-up were identified through a retrospective chart review. The necrotic capitate head was arthroscopically resected with removal of the lunate facet and preservation of the scaphoid and hamate facets. Wrist range of motion, grip strength, and radiographic parameters--carpal height ratio, radioscaphoid angle, and radiolunate angle-were determined before surgery and at the latest follow-up...
December 2015: Journal of Hand Surgery
https://www.readbyqxmd.com/read/26388012/post-traumatic-avascular-necrosis-of-the-proximal-carpal-row-a-case-report
#19
Ruben Manohara, Sandeep Jacob Sebastin, Mark Edward Puhaindran
We report a case of avascular necrosis of the scaphoid, lunate and triquetrum in a young 21-year-old patient, after a purely ligamentous peri-lunate dislocation of the wrist. He presented with a Mayfield III peri-lunate dislocation after a road traffic accident and underwent an open reduction and internal fixation. Post-operatively, the scapho-lunate gap widened after removal of the temporary K-wires, and he gradually developed avascular necrosis of the scaphoid, lunate and triquetrum, and osteoarthritis of his wrist...
October 2015: Hand Surgery
https://www.readbyqxmd.com/read/26387994/kienb%C3%A3-ck-disease-recent-advances-in-the-basic-science-assessment-and-treatment
#20
REVIEW
Gregory Ian Bain, Chong Jin Yeo, Levi Philip Morse
Kienböck disease is a disorder of impaired lunate vascularity which ultimately has the potential to lead to marked degeneration of the wrist and impaired wrist function. The aetiology of the avascular necrosis is uncertain, but theories relate to ulnar variance, variability in lunate vascularity and intraosseous pressures. Clinical symptoms can be subtle and variable, requiring a high index of suspicion for the diagnosis. The Lichtmann classification has historically been used to guide management. We present a review of Kienböck disease, with a focus on the recent advances in assessment and treatment...
October 2015: Hand Surgery
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