Vascularized Second Metacarpal Bone Graft for the Treatment of Idiopathic Osteonecrosis of the Capitate

Background: Idiopathic osteonecrosis of the capitate is rare condition with few reports of treatment using vascularized bone graft. Methods: A case of a 45-year-old woman with idiopathic necrosis of the capitate who underwent surgical treatment with a vascularized bone graft from the base of the second metacarpal bone is reported. Results: At 14 months postoperatively, the range of motion of her wrist was maintained, and localized wrist pain was relieved. Conclusions: This bone graft, which has a reliable pedicle with few anomalies, offers sufficient cancellous bone for the capitate, and can be harvested in the same operative field, is desirable for the treatment of osteonecrosis of the capitate.

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The vascular blood supply of the second metacarpal bone: anatomic basis for a new vascularized bone graft in hand surgery

Surgical and Radiologic Anatomy ◽

10.1007/bf01794884 ◽

1992 ◽

Vol 14 (2) ◽

pp. 103-112 ◽

Cited By ~ 34

Author(s):

G Pierer ◽

J Steffen ◽

H Hoflehner

Keyword(s):

Bone Graft ◽

Blood Supply ◽

Hand Surgery ◽

Metacarpal Bone ◽

Vascularized Bone Graft ◽

Anatomic Basis ◽

Vascularized Bone

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Bone Grafts for Scaphoid Nonunion: An Overview

Hand Surgery ◽

10.1142/s0218810415400043 ◽

2015 ◽

Vol 20 (02) ◽

pp. 222-227 ◽

Cited By ~ 11

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.

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Systematic review of Surgical Management of Early Stages of Kienböck’s Disease

QJM ◽

10.1093/qjmed/hcaa059.002 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A A K H Abouelela ◽

A Nabil ◽

M A Lami

Keyword(s):

Systematic Review ◽

Bone Graft ◽

Range Of Motion ◽

Core Decompression ◽

Vascularized Bone Graft ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Early Stages ◽

Vascularized Bone ◽

Kienbock’S Disease

Abstract Background Kienbock’s disease, or avascular necrosis of the lunate, is a rare debilitating condition that can lead to chronic pain and dysfunction in the wrist. It is classified into four stages according to lichtman staging. Different modalities of surgical treatment are proposed for early stages in which no carpal collapse is found. These modalities include radius core decompression, joint leveling procedures and vascularized bone graft. Objective To conduct a systematic review comparing the different surgical modalities in management of early stages of kienbock’s disease. Methodology The search was conducted by using the databases: MEDLINE, Cochrane library and JBJS {Journal of bone and joint Surgery} and PubMed. Data was independently extracted by two reviewers and crosschecked. Outcome measures included improvement of pain, range of motion, hand grip and postoperative complications. Results This systematic review included 11 paper of which 3 papers about core decompression, 7 about different joint leveling procedures and only one paper about vascularized bone graft. Core decompression papers included 41 patients most of them reported good improvement in the VAS score postoperatively. Joint leveling papers included 108 patients and reported mild improvement in range of motion and grip strength but complications like residual ulnar-sided wrist pain and carpal collapse were reported postoperatively. Vascularized bone graft paper included 13 patient of mean age 39 years and reported good improvement in grip strength, range of motion but mild improvement in VAS score. Conclusion Till now literature has no strong evidence to support that one of Core decompression, joint leveling procedures or lunate vascularized bone graft is superior in management of early stages of kienbock’s disease.

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