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Avascular necrosis lunate

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/26362838/hybrid-russe-procedure-for-scaphoid-waist-fracture-nonunion-with-deformity
#12
Steve K Lee, David J Byun, Jorge L Roman-Deynes, Zina Model, Scott W Wolfe
PURPOSE: To assess the results of a hybrid Russe procedure using a corticocancellous strut, cancellous autologous nonvascularized bone graft, and cannulated headless compression screw to reduce the deformity reliably from a collapsed scaphoid nonunion, provide osteoinductive stimulus, and stabilize the fracture for predictable union. METHODS: A hybrid Russe procedure was performed for scaphoid waist fracture nonunions with humpback deformity and no evidence of avascular necrosis...
November 2015: Journal of Hand Surgery
https://www.readbyqxmd.com/read/26324836/what-is-the-radiographic-prevalence-of-incidental-kienb%C3%A3-ck-disease
#13
Wouter F van Leeuwen, Stein J Janssen, Dirk P ter Meulen, David Ring
BACKGROUND: Kienböck disease is characterized by osteonecrosis of the lunate. Not all patients with radiographic evidence of the disease experience symptoms bothersome enough to consult a doctor. Little research has been performed on the prevalence of Kienböck disease, and the prevalence in the asymptomatic population is unclear. Knowledge of the natural course of the disease and how often patients are not bothered by the symptoms is important, because it might influence the decision as to whether disease-modifying treatment would be beneficial...
March 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26091230/delayed-avascular-necrosis-and-fragmentation-of-the-lunate-following-perilunate-dislocation
#14
Benjamin Wilke, Sanjeev Kakar
Perilunate and perilunate fracture dislocations are high-energy injuries with the wrist loaded in extension, ulnar deviation, and intercarpal supination. The force vector travels from a radial to a ulnar direction and can result in complex carpal instability. The diagnosis is often delayed, which can result in suboptimal outcomes. Nonoperative management can produce inferior results, with patients experiencing pain and weakness. Therefore, early treatment with open reduction and internal fixation is recommended to assess the osteochondral and ligamentous disruption and to achieve anatomic reduction of the carpus...
June 2015: Orthopedics
https://www.readbyqxmd.com/read/25530898/proximal-row-carpectomy-for-coexisting-kienb%C3%A3-ck-s-disease-and-giant-intraosseous-ganglion-of-the-scaphoid-a-case-report-and-review-of-the-literature
#15
Miguel Morón, Florian Oellig, Tomás Sánchez
The etiologies of Keinböck's disease and intraosseous ganglion remain unknown. Both entities are rare and the coexistence of these two pathologies in the same patient and hand is even less frequent. We report the case of a 40-year-old man with a longstanding history of martial arts practice (karate) who developed an avascular necrosis of the lunate concomitant with a giant intraosseous ganglion of the scaphoid bone successfully managed by proximal row carpectomy. We review the literature of these two diseases...
2014: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/25509771/-kirschner-wire-fixation-in-three-joints-combined-with-bone-anchor-repair-for-treatment-of-acute-perilunate-injury
#16
Yan Zhou, Shiqing Liu, Ling Yu, Qi Liao, Tao Huang, Zhao Qi, Chun Zhang
OBJECTIVE: To investigate the effectiveness of Kirschner wire fixation in scapholunate joint, capitolunate joint, and lunotriquetral joint combined with bone anchor repair for the treatment of acute perilunate injury. METHODS: Between January 2007 and January 2012, 35 cases of acute perilunate injury were treated. There were 30 males and 5 females with an average age of 45.5 years (range, 32-56 years). Fractures were caused by falling from height in 18 cases, by traffic accident in 11 cases, and by fall injury in 4 cases...
September 2014: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/25130008/partial-necrosis-of-the-lunate-after-a-translunate-palmar-perilunate-fracture-dislocation
#17
Mao Akane, Masahiro Tatebe, Kazuhito Iyoda, Kyotaro Ota, Katsuyuki Iwatsuki, Michiro Yamamoto, Hitoshi Hirata
We present an extreme rare case of traumatic partial avascular necrosis of the lunate after palmar perilunate dislocation with lunate fracture. A 32-year-old female was injured by motorcycle accident with palmar perilunate fracture dislocation and lunate fracture. Scapholunate and lunotriquetrum dislocations were reduced and fixed temporarily. The torn dorsal ligament was repaired. Considering close observation with both arthroscopy and fluoroscopy, we decided not to conduct open reduction and internal fixation for the lunate...
February 2014: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/24951206/imaging-of-kienb%C3%A3-ck-disease
#18
REVIEW
Javier Arnaiz, Tatiana Piedra, Luis Cerezal, John Ward, Alex Thompson, Jorge A Vidal, Ana Canga
OBJECTIVE: The purpose of this article is to provide an overview of Kienböck disease focusing on imaging findings, including the relevant anatomy, pathophysiology, and treatment of Kienböck disease and the differential diagnoses (pseudo-Kienböck lesions). CONCLUSION: Kienböck disease is a condition marked by avascular necrosis of the lunate bone. MRI is useful in diagnosis and staging and should be considered, after conventional radiography, for patients with suspected Kienböck disease...
July 2014: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/24876511/open-perilunate-injury-with-lunate-revascularization-after-complete-ligamentous-avulsion
#19
Dillon Arango, Nathan C Tiedeken, Mark Ayzenberg, James Raphael
Perilunate dislocations are a devastating injury to the carpus that carry a guarded long-term prognosis. Mayfield type 4 perilunate dislocations are rare, high-energy injuries that carry a risk for avascular necrosis (AVN) of the lunate. When AVN ensues and the carpus collapses, primary treatment with a proximal row carpectomy or arthrodesis has been advocated. This case reports a successful clinical result and revascularization of an extruded lunate with open reduction and internal fixation. This type 4, Gustilo grade 1 open perilunate dislocation exhibited complete avulsion of all lunate ligamentous attachments...
2014: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/24822779/avascular-necrosis-and-collapse-of-the-lunate-following-a-volar-perilunate-dislocation-a-case-report-and-review-of-this-complication-in-dislocations-of-the-wrist
#20
EDITORIAL
J J Mueller
Kienbock's disease occurs as a complication in less than 1% of volar perilunate dislocations of the wrist. One such case is reported here. The choice of open or closed treatment appears not to affect the incidence of avascular necrosis in this injury. Thus it is concluded that treatment should be dictated by the associated fractures or evidence of persistent scapholunate dissociation.
June 1984: Orthopedics
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