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

@article{Bochud1994KienbcksDE,
  title={Kienb{\"o}ck’s Disease, Early Stage 3––Height Reconstruction and Core Revascularization of the Lunate},
  author={R C Bochud and Ueli B{\"u}chler},
  journal={Journal of Hand Surgery (British and European Volume)},
  year={1994},
  volume={19},
  pages={466 - 478}
}
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… Expand
Stage IV Kienböck's disease: Proximal row carpectomy and application of RCPI implant.
TLDR
Proximal row carpectomy associated with the use of a pyrocarbon RCPI implant is a valid surgical technique for the treatment of stage IV Kienböck's disease and is a good alternative to carpal fusion, which leads to wrist immobility, and to total wrist joint replacement, which has a high incidence of dislocation and fracture. Expand
Treatment of Kienböck's Disease With Neutral Ulnar Variance by Distal Capitate Shortening and Arthrodesis to the Base of the Third Metacarpal Bone.
TLDR
Distal capitate shortening with capitometacarpal arthrodesis can alleviate pain and improve ROM and grip strength in patients with stage II Kienböck's disease, but not in those with stage IIA, and it cannot prevent carpal collapse, especially in stage IIIA of the disease. Expand
Stage 3 KienbÖck’s Disease: Reconstruction of the Fractured Lunate using a Free Vascularized Iliac Bone Graft and External Fixation
Eighteen patients with stage 3 Kienböck’s disease were treated by débridement of the necrotic core of the lunate and implantation of a free vascularized corticocancellous iliac bone. The wrist wasExpand
Vascularized os pisiform for reinforcement of the lunate in Kienböck's Disease: an average of 12 years of follow-up study.
TLDR
The results show high patient satisfaction and good function after vascularized bone transplantation for Kienböck's disease. Expand
Early results of partial capitate shortening osteotomy in management of Kienböck disease
TLDR
Partial capitate shortening is a simple and effective procedure for the management of ulnar neutral or ulnar positive Kienböck’s disease before the onset of radiocarpal arthrosis without violation of scaphocapitate joint thus avoiding carpal collapse that follows complete capitate longening. Expand
Lunate revascularization after capitate shortening osteotomy in Kienböck's disease.
  • A. Afshar
  • Medicine, Chemistry
  • The Journal of hand surgery
  • 2010
TLDR
Capitate shortening osteotomy is an efficient technique to induce the revascularization process in the early stages of Kienböck's disease. Expand
Die Pisiformetransposition nach Beck zur Behandlung der Lunatumnekrose im Stadium 2 nach Kienböck
TLDR
Following transposition of the pisiform to treat the necrotic lunate in stage II, good clinical results could be achieved and carpal collapse avoided in 84 % of the patients during the follow-up period. Expand
Open treatment of stage III Kienböck's disease with lunate revascularization compared with arthroscopic treatment without revascularization.
TLDR
Although the number of patients was small and the follow-up period was short, arthroscopic scaphocapitate fusion and capitate pole excision in stage IIIA and IIIB Kienböck's disease resulted in shorter operating time, shorter hospital stay, earlier return to unrestricted daily activities, and equal range of motion and grip strength as compared with open scaphscopic fusion and lunate revascularization. Expand
Radial recession osteotomy for Kienböck's disease.
TLDR
With rare exceptions, radial recession osteotomy relieves pain and improves function in Kienböck's disease and concomitant lunate revascularization or vascularized bone grafting may improve the radiographic result. Expand
Treatment of Kienböck's disease using a fourth extensor compartmental artery as a vascularized pedicle bone graft.
TLDR
Placing of a fourth ECA vascularized bone graft is a reliable alternative to other revascularization procedures for treatment of Kienböck's disease and is effective, minimally invasive, and associated with a low risk of pedicle kinking. Expand
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References

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Radial shortening for the treatment of Kienböck's disease—A 5- to 10-year follow-up
TLDR
This study is a 5- to 10-year follow-up of patients with early stages of Kienbock's disease and ulnar minus variant treated by radial shortening procedures, and patients returned to their normal activities. Expand
Ulnar lengthening in the treatment of Kienböck's disease.
TLDR
Twenty patients with Kienböck's disease were treated with a modification of the Persson ulnar-lengthening procedure to remove compressive stress from the damaged lunate, and the postoperative motions of the wrist were moderately improved. Expand
Radial Shortening for the Treatment of Kienböck's Disease
TLDR
Five of six patients with two or three stages of Kienbock's disease treated by radial shortening procedure showed the remodeling in the lunate bone, and compared with the pre-operative status, the mean range of the wrist motion improved and the mean grip strength increased. Expand
Kienböck's disease.
TLDR
Treatment of Kienböck's disease is conservative and includes immobilization, analgesics, and/or anti-inflammatory medication, and if symptoms are not relieved, then based on the degree of involvement, several surgical options exist that will provide a successful result. Expand
Kienböck's disease: the role of silicone replacement arthroplasty.
A review of thirty-eight patients with Kienböck's disease indicated that both delay in diagnosis and prolonged treatment by plaster immobilization led to progressive collapse of the lunate and anExpand
An approach to Kienböck's disease: triscaphe arthrodesis.
TLDR
It is believed that triscaphe arthrodesis with a silicone rubber lunate provides a means for load transference and heavy stress use capability of the hand. Expand
Kienböck's disease: the natural history of Kienböck's disease and consideration of lunate fractures.
TLDR
Patients with Kienböck's disease were relieved of pain and had functional wrists whether they were treated or not and regardless of the type of surgical treatment. Expand
Radial shortening for Kienböck's disease.
The subjective and objective results in seven patients with symptomatic Kienböck's disease treated by radial shortening demonstrate that this procedure is simple and effective in the early stages ofExpand
Kienböck's disease--the influence of arthrosis on ulnar variance measurements.
TLDR
It is concluded that over-representation of the so-called “ulnar minus variant” in Kienbock's disease is based on osteo-arthritic changes in the wrist, resulting in a pseudo-lengthening of the distal radius, and that this is therefore a consequence of the disease. Expand
Kienböck's disease—Update on silicone replacement arthroplasty
TLDR
In a previous paper, early lunate silicone replacement arthroplasty for Kienbock's disease was advocated because of poor results obtained in stage III disease, and an additional 16 patients have been operated on, and 12 underwent successful SRA. Expand
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