Treatment of Kienböck’s Disease With Neutral Ulnar Variance by Distal Capitate Shortening and Arthrodesis to the Base of the Third Metacarpal Bone

Hegazy, Galal; Akar, Ahmed; Abd-Elghany, Tharwat; Zayed, Emad; Shaheen, Elsayed; Mansour, Tarek

doi:10.1016/j.jhsa.2018.08.010

Cited by 4 publications

(3 citation statements)

References 37 publications

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“…Another study was performed on 10 patients 3 cases were stage II and 7 cases were III, achieved lunate revascularization which was detected by MRI in 6 patients. [23] In a study that used the same technique of treatment for Kienböck's disease [11] as those in group IIIA, and these results were also reported in other studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24] .…”

Section: Discussionsupporting

confidence: 60%

Kienböck's Diseases Treatment. A Novel Technique via Distal Capitate Shortening Accompanied by 3rd Metacarpal Base Fusion in Neutral Variance Ulna

Al-Ashhab

Farag

2021

Benha Medical Journal

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Background: Since there is not a definite cause for Kienböck's diseases despite appropriate knowledge of lunate bone blood supply, so there is a great debate about the ideal treatment protocol for treatment of Kienböck's diseases. Objective: The aim of this study is to assess outcome of combining distal capitate shortening and fusion to the base of the third metacarpal bone for treatment of Kienböck's disease (Lichtman stage II or stage IIIA) with neutral ulna variance. Methods: Twenty patients with 20 consecutive Kienböck's disease, their age mean was 26.1(SD 5.6) y. Patients were evaluated radiologically and clinically including pre-and postoperatively for pain, (ROM) and grip strength. Functional evaluation was carried out using (MMWS). Results: The final postoperative (MMWS) showed increasing from 17 (SD 2.5) to 88.5 (SD7.3). Conclusion: The technique of distal capitate shortening with capito-metacarpal fusion yielded satisfactory results especially for treatment of stage II, than in stage IIIA.

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Section: Discussionsupporting

confidence: 60%

Kienböck's Diseases Treatment. A Novel Technique via Distal Capitate Shortening Accompanied by 3rd Metacarpal Base Fusion in Neutral Variance Ulna

Al-Ashhab

Farag

2021

Benha Medical Journal

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“…Distal capitate osteotomy at the carpometacarpal joint is combined with a fusion of the capitate to the base of the metacarpals (Hegazy et al., 2019), again trying to prevent proximal migration of the distal carpal row.…”

Section: Treatment Of Kdmentioning

confidence: 99%

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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“… 48 Twenty-two patients followed at 30 months after capitate osteotomy demonstrated that L/S stage II patients improved to a wrist ROM of 73% contralateral and GS 75% of contralateral, but L/S stage III patients did not improve and further deteriorated. 49 …”

Section: Early Kienböck'smentioning

confidence: 99%

Matching Kienböck's Treatment Options to Specific Features of Each Case

Henry

Lundy

Henry

2023

Journal of Hand and Microsurgery

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Kienböck's disease is best understood as a continuous interaction between compromised perfusion and structural deterioration that transitions from an early phase to a late phase. Existing literature has failed to identify any one superior treatment for Kienböck's; many studies even demonstrate no advantage for surgery compared with the natural history. Surgical interventions for early and transitional Kienböck's are designed to preserve or reconstruct the lunate. However, in most studies, the only tool used to assess the lunate itself has been plain radiography that neither reveals critical architectural details (demonstrated by computed tomographic scan) nor the vascular status (demonstrated by magnetic resonance imaging). Most articles, therefore, do not adequately define the preoperative status of the lunate or its alteration through surgical intervention. Critical preoperative features that are best demonstrated by these advanced imaging studies have specific anatomic and physiologic relationships that better correspond with certain surgical interventions, which also pair better with specific patient characteristics. This review explains how to identify, analyze, and strategically match these variables with the treatment interventions available for Kienböck's patients through the early, transitional, and late phases of the disease.

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Treatment of Kienböck’s Disease With Neutral Ulnar Variance by Distal Capitate Shortening and Arthrodesis to the Base of the Third Metacarpal Bone

Cited by 4 publications

References 37 publications

Kienböck's Diseases Treatment. A Novel Technique via Distal Capitate Shortening Accompanied by 3rd Metacarpal Base Fusion in Neutral Variance Ulna

Kienböck's Diseases Treatment. A Novel Technique via Distal Capitate Shortening Accompanied by 3rd Metacarpal Base Fusion in Neutral Variance Ulna

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

Matching Kienböck's Treatment Options to Specific Features of Each Case

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