Lunate plasty for Kienböck's disease: use of a pedicled vascularised radial bone graft combined with shortening of the capitate and radius

Hand Surg. 2001 Dec;6(2):145-56. doi: 10.1142/s0218810401000618.

Abstract

We treated eight patients with Kienböck's disease (two patients each with stage 1, 2, 3a and 3b disease by Lichtman's classification) by removing a pedicled, vascularised bone segment from the dorsal aspect of the distal radius and engrafting it into the lunate. Additional shortening of the radius was performed in patients with the ulna-minus or null variant. Shortening of the capitate and capito-hamate fusion were also performed in patients with stage 3 disease. All patients were relieved of their wrist pain at rest and during movement, and the mean grip strength increased from 37% of that in the contralateral hand before surgery to 80% after surgery. The mean post-operative range of motion in the affected wrist was 92% of that in the opposite wrist in patients with stage 1 and 2 disease, and 53% in patients with stage 3 disease. Post-operative assessment revealed that four patients had excellent results, three had good results, and one had a fair result.

MeSH terms

  • Adult
  • Aged
  • Bone Transplantation / methods*
  • Carpal Bones / blood supply*
  • Carpal Bones / diagnostic imaging
  • Carpal Bones / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Lunate Bone / blood supply*
  • Lunate Bone / diagnostic imaging
  • Lunate Bone / surgery*
  • Male
  • Middle Aged
  • Osteochondritis / diagnostic imaging
  • Osteochondritis / physiopathology*
  • Osteochondritis / surgery*
  • Radiography
  • Radius / blood supply*
  • Radius / diagnostic imaging
  • Radius / surgery*
  • Range of Motion, Articular / physiology
  • Recovery of Function / physiology
  • Severity of Illness Index
  • Surgical Flaps / blood supply*
  • Surgical Flaps / physiology
  • Wrist Joint / diagnostic imaging
  • Wrist Joint / physiopathology*
  • Wrist Joint / surgery*