Long-Term Clinical and Radiological Outcomes of Radial Shortening Osteotomy and Vascularized Bone Graft in Kienböck Disease

2013 ◽  
Vol 38 (2) ◽  
pp. 289-296 ◽  
Author(s):  
Ahmadreza Afshar ◽  
Karim Eivaziatashbeik
Keyword(s):  
Bone Graft ◽  
Vascularized Bone Graft ◽  
Shortening Osteotomy ◽  
Kienböck Disease ◽  
Vascularized Bone

Long-Term Results of Vascularized Bone Graft for Stage III Kienböck Disease

2013 ◽  
Vol 38 (5) ◽  
pp. 904-908 ◽  
Author(s):  
Hiroyoshi Fujiwara ◽  
Ryo Oda ◽  
Shinsuke Morisaki ◽  
Kazuya Ikoma ◽  
Toshikazu Kubo
Keyword(s):  
Bone Graft ◽  
Stage Iii ◽  
Long Term Results ◽  
Vascularized Bone Graft ◽  
Kienböck Disease ◽  
Vascularized Bone

Is Joint Levelling Procedure Better than Temporary Scaphocapitate Pinning in Patients Undergoing Vascularized Bone Graft for Kienböck Disease?

2019 ◽  
Vol 24 (04) ◽  
pp. 428-434
Author(s):  
Hyoung Seok Jung ◽  
Ho Won Lee ◽  
Min Jong Park
Keyword(s):  
Visual Analogue Scale ◽  
Bone Graft ◽  
Analogue Scale ◽  
Vascularized Bone Graft ◽  
Plain Radiographs ◽  
Clinical Evaluations ◽  
Shortening Osteotomy ◽  
Kienböck Disease ◽  
Vascularized Bone ◽  
Better Than

Background: Although there have been many studies of the vascularized bone graft (VBG) or unloading procedures alone for the treatment of Kienböck disease, little information has been reported about patients treated with VBG combined with unloading procedures. The purpose of this study is to 1) describe the outcomes in patients treated with VBG combined with unloading procedures, 2) compare the outcomes according to the unloading procedures and 3) find any radiologic parameters affecting revascularization in Kienböck disease. Methods: A retrospective review was performed involving in 20 patients undergoing 4th and 5th extensor compartmental VBG with unloading procedures for Kienböck disease from 2010–2015. After VBG in all patients, unloading procedures were additionally performed depending on the ulnar variance. These additional operations included joint leveling procedures (radial and capitate shortening osteotomy) or temporary scaphocapitate pinning. Radiologic outcome was evaluated according to Lichtman stage and presence of revascularization evidence. Clinical evaluations included wrist range of motion, grip strength, visual analogue scale (VAS), and Mayo wrist score. Results: VBG with joint leveling procedures was performed in 11 patients (5 radial shortening and 6 capitate shortening) and VBG with temporary scaphocapitate pinning was performed in 9 patients. Although clinical outcomes were not significantly different according to the unloading procedures, there were significantly more patients with evidence of healing of osteonecrosis on radiographs in joint leveling procedure group than temporary scaphocapitate pinning group. Overall, evidence of healing of osteonecrosis was found on plain radiographs in 11 patients and was not found in 9 patients. However, there were no significant preoperative radiological parameters affecting revascularization on radiographs. Conclusions: Not all patients had evidence of revascularization on radiography after VBG combined with unloading procedures for Kienböck disease. However, among the unloading procedures, joint-leveling procedures positively influenced the revascularization process.

Bone Grafts for Scaphoid Nonunion: An Overview

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 222-227 ◽  
Author(s):  
Steven E.R. Hovius ◽  
Tim de Jong
Keyword(s):  
Surgical Treatment ◽  
Bone Graft ◽  
Bone Grafts ◽  
Good Position ◽  
Vascularized Bone Graft ◽  
Scaphoid Nonunion ◽  
Non Union ◽  
Non Surgical Treatment ◽  
Vascularized Bone

The scaphoid is the most common fractured bone in the wrist. Despite adequate non-surgical treatment, around 10% to 15% of these fractures will not heal. Untreated scaphoid non-union can cause a scaphoid non-union advance collapse (SNAC), this is a progressive deformity and can cause degenerative changes in the wrist. Surgery is focused on achieving consolidation, pain reduction and a good position of the scaphoid while preventing osteoarthritis in the long-term. Surgery consists of reduction and fixation of the scaphoid with a non-vascularized or vascularized bone graft. An overview of the most used vascularized and non-vascularized bone grafts and their indications are presented.

The treatment of Kienböck disease with vascularized bone graft from dorsal radius

2008 ◽  
Vol 129 (2) ◽  
pp. 171-175 ◽  
Author(s):  
Taçkin Özalp ◽  
Huseyin Serhat Yercan ◽  
Guvenir Okçu
Keyword(s):  
Bone Graft ◽  
Vascularized Bone Graft ◽  
Kienböck Disease ◽  
Vascularized Bone

Vascularized second metatarsophalangeal joint transfer for radial deficiency – an update

2018 ◽  
Vol 43 (9) ◽  
pp. 907-918 ◽  
Author(s):  
Simo K. Vilkki ◽  
Pasi Paavilainen
Keyword(s):  
Bone Graft ◽  
Metatarsophalangeal Joint ◽  
Vascularized Bone Graft ◽  
Proximal Fibula ◽  
Type Iii ◽  
Radial Deviation ◽  
Term Evaluation ◽  
Conventional Methods ◽  
Vascularized Bone

Vascularized second metatarsophalangeal joint transfer offers a possibility to reconstruct the radial support which is lacking in radial dysplasia. Our experience from 1987 to 2017 with 34 congenital radial club hand reconstructions have allowed a possibility for long-term evaluation of the method. Compared with conventional methods, second metatarsophalangeal joint transfer results in better wrist mobility and does not restrict typical ulnar growth. The balance of the wrist remains good until age 11. Thereafter, the growth of the vascularized bone graft transfer matches only partially the distal ulnar growth in adolescence, resulting in mild recurrence of radial deviation. A new option to create a two-bone forearm in selected Bayne-Klug Type III radial dysplasia cases will allow a relatively good pro-supination ability. Potentially, a proximal fibular epiphyseal transfer could be a future solution. Currently, a safe harvest of the proximal fibula at childhood remains controversial.

scholarly journals The Fourth Extensor Compartment Artery Vascularized Bone Graft of the Distal Radius for CMC Fusion in the Treatment of Carpal Boss: A Case Report

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP88-NP91 ◽  
Author(s):  
Jorge G. Boretto ◽  
David Fernandez-Fernandez ◽  
Gerardo Gallucci ◽  
Pablo De Carli
Keyword(s):  
Bone Graft ◽  
Distal Radius ◽  
Bone Grafts ◽  
Vascularized Bone Graft ◽  
Daily Life Activities ◽  
Carpometacarpal Joints ◽  
Effective Treatment Modality ◽  
Kienböck Disease ◽  
Extensor Compartment ◽  
Vascularized Bone

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. Results: At 6 weeks postoperative bone union was achieved. At 2 years follow-up the patient was able to perform daily life activities without pain. Conclusions: The fourth ECA VBG with reverse blood flow from the dorsal intercarpal arch allowed the graft to reach the CMC. A solid fusion was obtained at 6 weeks due to the biological advantage of the VBG.

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