Capitate shortening osteotomy with or without vascularized bone grafting for the treatment of early stages of Kienböck’s disease

Hegazy, Galal; Seddik, Mahmoud; Massoud, Abdel-Hakim; Imam, Rashed; Alshal, Ehab; Zayed, Emad; Darweash, Ahmed

doi:10.1007/s00264-021-05103-4

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…Bone-shortening technique is used for bone defects lower than 8 cm of size, but it needs a long hospitalization period and multiple surgery procedures and causes chronic pain and risks such as microbial infection, osteomyelitis, blood vessel and nerve damage, and poor bone healing. , The use of prosthesis allows surgeons to replace the fractured limb using megaprosthesis, but this approach is performed only in special cases such as malignant tumors, nonneoplastic conditions, major trauma, or end-stage revision arthroplasty and extensive metastatic diseases. , Internal fixation techniques, such as plates or intramedullary nail, are used to stabilize bone gaps. However, these techniques increase the risk of complications due to infections, leading to larger defects .…”

Section: Introductionmentioning

confidence: 99%

Bone Bricks: The Effect of Architecture and Material Composition on the Mechanical and Biological Performance of Bone Scaffolds

et al. 2022

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Large bone loss injuries require high-performance scaffolds with an architecture and material composition resembling native bone. However, most bone scaffold studies focus on three-dimensional (3D) structures with simple rectangular or circular geometries and uniform pores, not able to recapitulate the geometric characteristics of the native tissue. This paper addresses this limitation by proposing novel anatomically designed scaffolds (bone bricks) with nonuniform pore dimensions (pore size gradients) designed based on new lay-dawn pattern strategies. The gradient design allows one to tailor the properties of the bricks and together with the incorporation of ceramic materials allows one to obtain structures with high mechanical properties (higher than reported in the literature for the same material composition) and improved biological characteristics.

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Section: Introductionmentioning

confidence: 99%

Bone Bricks: The Effect of Architecture and Material Composition on the Mechanical and Biological Performance of Bone Scaffolds

et al. 2022

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“…CSO at the level of the STT joint can be done in isolation or combined with other procedures, such as wrist arthroscopy (Bain et al., 2020), capitohamate fusion (to prevent proximal migration of the distal carpal row) (Almquist, 1986), hamate shortening (Rabarin et al., 2010) and vascularized lunate grafting (Hegazy et al., 2021) when the lunate height is collapsed.…”

Section: Treatment Of Kdmentioning

confidence: 99%

“…Plates, Kirschner wires, staples or screws have been used as fixation methods for both types of osteotomies, with no reported cases of nonunion. Pain, grip strength and functional improvement are usually expected after the procedure, and better outcomes when the procedures are done in the earlier stages (Bain et al., 2020; Hegazy et al., 2021).…”

Section: Treatment Of Kdmentioning

confidence: 99%

“…CSO is indicated when KD occurs in ulna positive wrists, and may also be indicated in neutral variance (Almquist, 1986). The best outcomes of the procedure are expected in the early stages of the disease, when the lunate height is still maintained (Hegazy et al, 2021) and the lunocapitate joint surface is found to be preserved on arthroscopic examination (Bain et al, 2020). The procedure can be performed in two different ways.…”

Section: Capitate Shortening Osteotomymentioning

confidence: 99%

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Kienböck’s disease: preventing disease progression in early-stage disease

Salvà-Coll

Esplugas

Carreño

et al. 2023

J Hand Surg Eur Vol

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Currently Kienböck’s disease remains an ‘unsolved’ problem in hand surgery. Different factors have been associated with the avascular necrosis of the lunate. Mechanical, vascular and biological factors, alone or in combination, may have an influence in the aetiopathogenesis and determine the progress of the disease and even the results of the treatment. This is especially relevant in the early stages, in which conservative or surgical treatment may modify the natural history of the disease, maintaining the lunate structure and thus preserving the joint surfaces. There are multiple surgical treatments for Kienböck’s disease in the early stages, before lunate collapse; each one is based on one of the possible factors that can cause avascular necrosis of the lunate. The objective is not only to treat symptoms but to prevent progression. This article is a review of the most frequent treatments used in the early stages and a personal view of the authors. Level of evidence: V

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“…In stage II patients, there was no evidence of superiority of large bone shortening combined with large bone shortening alone. An important prognostic factor in treatment results is the lunate height index (17).…”

Section: Figure 3 Degree Of Carpal Collapse By Salmon Et Al Through T...mentioning

confidence: 99%

Kienböck's Disease, Avascular Necrosis of the Lunate

Pesántez

García

Banegas

et al. 2022

EPRA

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Introduction: Avascular necrosis of the lunate bone was described in 1910 by the Austrian radiologist Robert Kienböck, which is named after him. A mixture of different factors such as mechanical, vascular and genetic predisposition may be related to the pathogenesis of this disease. As for the natural evolution of the disease, failure in early diagnosis and early treatment may lead to a gradual evolution from stage I to stage IV, causing discomfort to the patient. Objective: to detail the current information related to avascular necrosis of the lunate, description, etiology, classification, imaging presentation and management of Kienböck's disease. Methodology: a total of 32 articles were analyzed in this review, including review and original articles, as well as clinical cases, 20 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: Kienböck, avascular necrosis of the lunate and lunatomalacia. Results: it is the second most frequent cause of avascular necrosis of the carpal bones and generally affects males between 20 and 40 years of age. Nuclear magnetic resonance has a greater contribution due to greater sensitivity and detection of radiographically occult cases, computed tomography also has a good specificity at the time of diagnosis. Radiography at the beginning of the disease does not present evident changes and nuclear scintigraphy presents non-specific findings. In the first stage, the treatment is based on immobilization with a plaster cast or splints. When incomplete necrosis is evidenced in the second stage, conservative treatment can be performed, however with complete necrosis or in the third and fourth stage, it requires "joint leveling" surgery and probably vascular bone grafting or transfer of branches of adjacent arteries. Stage IIIA usually merits lunate restoration, in stage IIIB and Lichtman IV wrist arthrodesis can be used. Conclusions: Kienböck's disease presents with unilateral pain over the dorsal aspect of the wrist, weakness and limited wrist motion, in addition to functional impotence, decreased grip strength, wrist edema, sensory disturbances in the median nerve territory and synovitis, depending on the stage. It is related to the following variables such as ulnar minus or ulnar negative variation, vascular contribution of the lunate bone, morphology of the lunate, radial inclination angle. The diagnosis is clinical and imaging where Lichtman's classification is useful. Treatment will depend on the cause and also on the stage of the disease.

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Capitate shortening osteotomy with or without vascularized bone grafting for the treatment of early stages of Kienböck’s disease

Cited by 7 publications

References 23 publications

Bone Bricks: The Effect of Architecture and Material Composition on the Mechanical and Biological Performance of Bone Scaffolds

Bone Bricks: The Effect of Architecture and Material Composition on the Mechanical and Biological Performance of Bone Scaffolds

Kienböck’s disease: preventing disease progression in early-stage disease

Kienböck's Disease, Avascular Necrosis of the Lunate

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