Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid

Kuhlmann, JD; Mimoun, Maurice; Boabighi, A.; Baux, S

doi:10.1016/0266-7681(87)90014-3

Cited by 185 publications

(98 citation statements)

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“…We have resorted to the work of Kuhlman et al, 8 to describe a graft harvested from the volar aspect of the radius based on the transverse volar carpal artery whose pedicle is long enough to allow placement of the graft into the scaphoid or the lunate without any tension (Fig. 1).…”

Section: Anatomical Basismentioning

confidence: 98%

Revascularization of the lunate by a volar vascularized bone graft and an osteotomy of the radius in treatment of the Kienböck's disease

Mathoulin

Wahegaonkar

2009

Microsurgery

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Kienböck, a German radiologist, described avascular necrosis of the lunate (Kienböck's disease) in 1910. The epidemiology and etiology are not well-known and always has been debated. A negative ulnar variance is considered as a predisposing factor for Kienböck's disease by the majority of the authors. The treatment depends upon the stage of the disease at the time of presentation and diagnosis. Radial shortening and lengthening of the ulna are biomechanically satisfactory procedures because they increase the load sharing of the ulna and result in decompression of the lunate. Revascularization of the lunate by shortening of the radius may appear to be a very bold and ambitious technique. In very advanced cases, palliative procedures like wrist denervation, resection of the proximal carpal row, or wrist arthrodesis are the techniques resorted to. We report our experience of a series of 22 operated cases between 1994 and 2000 with a minimum follow up of 5 years. All cases were treated with an anterior vascularized bone graft based on the volar carpal artery associated to an osteotomy of the radius.

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Section: Anatomical Basismentioning

confidence: 98%

Revascularization of the lunate by a volar vascularized bone graft and an osteotomy of the radius in treatment of the Kienböck's disease

Mathoulin

Wahegaonkar

2009

Microsurgery

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“…1,14,15 For waist nonunions, bone or periosteal grafts from the palmar-ulnar aspect of the radial metaphysis may be used, 2,14,16,17 whereas for more proximal nonunions, the grafts from the dorsal-radial side of the distal radius are more appropriate 15,18,19 (Figs. 1a-1d).…”

Section: Discussionmentioning

confidence: 99%

Donor sites for pedicled skeletal grafts of the hand, wrist, and forearm

Dailiana¹,

Malizos²,

Varitimidis³

et al. 2009

Microsurgery

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Pedicled bone and periosteal grafts provide successful reconstruction of skeletal problems of the distal radius, wrist, and hand. The purpose of this study was to evaluate the available alternatives and to propose the most suitable skeletal grafts for the reconstruction of the distal radius, and the carpal and hand bones. The alternative donor sites (dorsal and palmar distal radius, and metacarpals), their pedicles, and the potential coverage area in relation to specific wrist and hand pathology were determined in the cadaveric dissections. In the clinical setting, 75 pedicled grafts were used for the treatment of scaphoid nonunions (62 cases), lunate necrosis (8 cases), reconstruction of the metacarpal defects (2 cases), and wrist fusions (3 cases). All alternatives have the advantage of a single approach that may be performed under tourniquet control, from the same team. Among the available alternatives, surgeon's familiarity plays the most important role for the final selection of the graft.

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“…43,44 In Kienböck's disease-vascularized bone grafts have been used for the reconstruction and revascularization of the lunate. The grafts from the distal radius may be palmar or dorsal.…”

Section: Large Vascularized Bone Graftsmentioning

confidence: 99%