Medial femoral trochlea flap reconstruction versus proximal row carpectomy for Kienböck’s disease: a morphometric comparison

2021 ◽  
pp. 175319342110318
Author(s):  
Amelia C. Van Handel ◽  
Leigha M. Lynch ◽  
Jimmy H. Daruwalla ◽  
James P. Higgins ◽  
Kari L. Allen ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Proximal Row Carpectomy ◽  
Geometric Morphometric ◽  
Femoral Trochlea ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Articular Surfaces ◽  
Surgical Options ◽  
Geometric Morphometric Analysis ◽  
Kienbock’S Disease

Surgical options for advanced Kienböck’s disease include proximal row carpectomy or lunate reconstruction with a medial femoral trochlea osteochondral flap. This study compares morphology of the proximal capitate and the medial femoral trochlear surfaces to the proximal lunate using three-dimensional geometric morphometric analysis. Virtual articular surfaces were extracted from MRI studies of ten healthy volunteers. Distances between corresponding points on the proximal lunate and proximal capitate or medial femoral trochlear surfaces were measured. In seven subjects, mean inter-surface distance for the medial femoral trochlea–proximal lunate pair was significantly lower than the proximal capitate–proximal lunate pairing. In three subjects, mean proximal capitate–proximal lunate distance was significantly lower. We conclude that the medial femoral trochlear flap was anatomically closer to the shape of the proximal lunate in the majority of the examined subjects. However, we found that in three out of ten cases, the proximal capitate was a better match.

Kienböck’s Disease in Cerebral Palsy

1998 ◽  
Vol 23 (6) ◽  
pp. 746-748 ◽  
Author(s):  
C. LECLERCQ ◽  
C. XARCHAS
Keyword(s):  
Cerebral Palsy ◽  
Proximal Row Carpectomy ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Kienbock’S Disease

The incidence of Kienböck's disease is known to be higher in cerebral palsy patients, but little has been written on treatment. We report a case of Kienböck's disease in a young man affected by cerebral palsy. A proximal row carpectomy was done, which relieved spasticity at the same time as treating the disease.

Lunate trabecular structure: a cadaveric radiograph study of risk factors for Kienböck's disease

2009 ◽  
Vol 35 (2) ◽  
pp. 120-124 ◽  
Author(s):  
K. L. Owers ◽  
P. Scougall ◽  
D. Dabirrahmani ◽  
G. Wernecke ◽  
A. Jhamb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulnar Variance ◽  
Trabecular Structure ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Articular Surfaces ◽  
Joint Surfaces ◽  
Conventional Ct ◽  
Distal Joint ◽  
Kienbock’S Disease

The aetiology of Kienböck's disease is unknown. Ulnar variance and lunate shape are possible mechanical risk factors. This study assessed the trabecular structure in 29 cadaveric lunates using microCT and correlated this with ulnar variance and lunate shape on plain radiographs and with bone density assessed using conventional CT. The bony trabeculae within the lunate were shown to run almost perpendicular to the proximal and distal joint surfaces in the coronal plane; these trabeculae met the subchondral bone at an angle between 72–102°. In lunates whose proximal and distal articular surfaces are not parallel, the trabecular orientation may be less able to resist compressive forces and more susceptible to fracture.

Proximal Row Carpectomy Versus Limited Wrist Arthrodesis for Advanced Kienböck’s Disease

1998 ◽  
Vol 23 (6) ◽  
pp. 741-745 ◽  
Author(s):  
R. NAKAMURA ◽  
E. HORII ◽  
K. WATANABE ◽  
E. NAKAO ◽  
H. KATO ◽  
...  
Keyword(s):  
Grip Strength ◽  
Wrist Pain ◽  
Wrist Flexion ◽  
Proximal Row Carpectomy ◽  
Wrist Arthrodesis ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Flexion Extension ◽  
Kienbock’S Disease

The outcomes in 20 patients with advanced Kienböck's disease treated by proximal row carpectomy (seven patients) or limited wrist arthrodesis (13 patients) were reviewed retrospectivey. Postoperatively, the results were more satisfactory in terms of wrist pain, the range of wrist flexion–extension, and grip strength following limited wrist arthrodesis than after proximal row carpectomy, although the differences were not statistically significant. We recommend scaphotrapeziotrapezoid arthrodesis in selected patients with advanced Kienböck's disease who have a fragmented lunate.

The free vascularized lateral femoral trochlea osteochondral graft: a reliable alternative for Stage III Kienböck’s disease

2021 ◽  
pp. 175319342110193
Author(s):  
Christian M. Windhofer ◽  
Maria Anoshina ◽  
Patrick Ivusits ◽  
Heinz P. Bürger
Keyword(s):  
Graft Loss ◽  
The Other ◽  
Stage Iii ◽  
Dash Score ◽  
Osteochondral Graft ◽  
Femoral Trochlea ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
The Mean ◽  
Kienbock’S Disease

Lunate reconstruction using a lateral femoral trochlea osteochondral graft was carried out in 27 patients with Stage III Kienböck’s disease from 2012 to 2019. Twenty-three of these patients could be followed-up in this retrospective study. Ten were women and 13 men. Nine were Lichtman Stage IIIA, seven Stage IIIB and seven Stage IIIC. The mean follow-up was 39 months (range 12–86). Bony consolidation was found in 18 of the 23 patients, with no graft loss. The mean Disabilities of the Arm, Shoulder and Hand score (DASH score) was 11 and the Modified Mayo Wrist Score was 83. There were only two radiological deteriorations, with the same or improved Lichtman classifications in the other patients and a significant reduction in pain. Postoperative extension of the wrist (52°) and flexion (48°) were comparable with preoperative values and, respectively, 81% and 72% of the contralateral side. Grip strength and pinch grip were 32 kg and 12 kg, 88% and 94% of the other hand, respectively, and an insignificant increase compared with the preoperative values. The vascularized lateral femoral trochlea osteochondral graft yields good short- and mid-term results in Grade III Kienböck’s disease. Level of evidence: IV

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