Capitate Shortening Osteotomy and Vascularized Bone Grafting for Treatment of Kienböck's Disease

2009 ◽  
Vol 34 (7) ◽  
pp. 16
Author(s):  
Julie E. Adams ◽  
Terri M. Skirven ◽  
A. Lee Osterman ◽  
Randall W. Culp
Keyword(s):  
Bone Grafting ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Shortening Osteotomy ◽  
Vascularized Bone ◽  
Kienbock’S Disease

Kienböck’s Disease, Early Stage 3––Height Reconstruction and Core Revascularization of the Lunate

1994 ◽  
Vol 19 (4) ◽  
pp. 466-478 ◽  
Author(s):  
R. C. BOCHUD ◽  
U. BÜCHLER
Keyword(s):  
Bone Grafting ◽  
Early Stage ◽  
Disease Process ◽  
Wrist Motion ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Shortening Osteotomy ◽  
Final Score ◽  
Carpal Height ◽  
Kienbock’S Disease

Early stage 3 Kienböck’s disease has been treated by inner débridement, recontouring, height reconstruction, bone grafting and core revascularization of the lunate; additional procedures included temporary external fixation of the wrist and/or shortening osteotomy of the radius in selected cases. 26 patients, representing an uninterrupted series of 28 procedures, were followed-up for an average of 6.7 years (range 2.5–9.3 years) with periodic clinical and radiographic evaluations until they reached the final comprehensive assessment that included trispiral tomography and MRI. Every patient was subjectively improved, pleased with the result and able to resume his previous job. Pain intensity, rated on a zero to five scale, improved from 2.5 points pre-operatively to a final score of 0.8 points. Wrist motion gained slightly. Grip strength improved significantly. Lunate reconstruction proved successful in 37% of the cases; in an additional 23%, the disease process was stabilized. Carpal height decreased 4.7%; ulnar translation was not substantially altered. Arthrosis increased postoperatively in 55%, remained unchanged in 36% and progressed in 9%. Overall, 43% good and excellent, 43% fair and 14% poor results were observed.

scholarly journals Kuhlmann vascularized bone grafting for treatment of Kienböck’s disease: a case report

2016 ◽  
Vol 24 ◽  
Author(s):  
Mohamed Ali Sbai ◽  
Hichem Msek ◽  
Sofien Benzarti ◽  
Monia Boussen ◽  
Riadh Maalla
Keyword(s):  
Case Report ◽  
Bone Grafting ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Vascularized Bone ◽  
Kienbock’S Disease

Capitate shortening osteotomy and vascularized bone grafting for Kienböck’s disease in ulnar positive or neutral wrists

2021 ◽  
pp. 175319342199991
Author(s):  
Alistair R. Hunter ◽  
David Temperley ◽  
Ian A. Trail
Keyword(s):  
Medium Term ◽  
Level Of Evidence ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Evaluation Scores ◽  
Shortening Osteotomy ◽  
Functional Scores ◽  
Mri Scans ◽  
Vascularized Bone ◽  
Kienbock’S Disease

We report the short- to medium-term outcomes for patients with Kienböck’s disease and ulnar positive or neutral wrists treated by capitate shortening osteotomy combined with a 4 + 5 extensor compartmental artery vascularized bone graft placed in the lunate. This is a retrospective study of seven consecutive patients with Lichtman Stage 2 to 3B. Radiological and clinical outcomes were evaluated. Six patients maintained their Lichtman stage, one progressed. Mean time to union of the capitate was 10 weeks. Five of six lunates were completely revascularized on MRI scans, with one partial revascularization. Mean follow-up for functional scores was 40 months (range 15 to 62). Mean pain score improved significantly from 7.4/10 preoperatively to 1.9/10 postoperatively, and patient satisfaction was 9.2/10. Mean postoperative Quick Disabilities of Arm, Shoulder and Hand, Patient Evaluation Measure and Patient-Rated Wrist Evaluation scores were improved. All patients returned to their previous work. We conclude that this procedure has good short- to medium-term outcomes. Level of evidence: IV

scholarly journals Evaluation of Kienböck's Disease Treated by Camembert Osteotomy at Seven Years

2019 ◽  
Vol 08 (03) ◽  
pp. 226-233 ◽  
Author(s):  
Emmanuel J. Camus ◽  
Luc Van Overstraeten
Keyword(s):  
Case Series ◽  
Ulnar Variance ◽  
Wedge Osteotomy ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Ulnar Shortening Osteotomy ◽  
Case Series Study ◽  
Shortening Osteotomy ◽  
Functional Scores ◽  
Kienbock’S Disease

AbstractIn Kienböck's disease, radius shortening osteotomy is the most common treatment. The Camembert procedure is a wedge osteotomy that shortens only the radius facing the lunate. Its aim is to offload the lunate by redirecting the compression stress of the grip forces toward the scaphoid. The purpose of this study was to determine if the Camembert osteotomy is effective in improving clinical symptoms and limits lunate collapse. The series include 10 patients who underwent a Camembert osteotomy for Kienböck's disease between 2002 and 2012 (one bilaterally). They are six men and four women, aged 40.6 years. Five patients had an additional ulnar shortening osteotomy if ulnar variance was neutral or positive. The mean follow-up is 7 years. Preoperatively, range of motion, grip strength, pain, and functional scores were poor. All osteotomies healed within 3 months. Extension, ulnar deviation, grip, functional scores improved significantly. In 10 cases, there were improvement in the T1 and T2 signals on the magnetic resonance imaging (MRI). There was no lunate collapse. This series shows good results with no worsening of the lunate shape. There was no ulnocarpal impingement. The Camembert osteotomy proposes to offload the lunate and redirect strains toward the scaphoid. The supposed interest is to protect the lunate from collapse. In this small series, the Camembert osteotomy improved function in patients with early stage Kienböck's disease. MRI aspects improve in most cases and no patients collapsed. Camembert can be used in combination with a Sennwald's ulnar shortening when ulnar variance is neutral or positive. Authors propose this procedure for Lichtman's stages 1–2–3A if there are no cartilage or ligament lesions. This is a Level IV, case series study.

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