title: Lunate plasty for Kienböck's disease: use of a pedicled vascularised radial bone graft combined with shortening of the capitate and radius.
abstract: We treated eight patients with Kienböck's disease (two patients each with stage 1, 2, 3a and 3b disease by Lichtman's classification) by removing a pedicled, vascularised bone segment from the dorsal aspect of the distal radius and engrafting it into the lunate. Additional shortening of the radius was performed in patients with the ulna-minus or null variant. Shortening of the capitate and capito-hamate fusion were also performed in patients with stage 3 disease. All patients were relieved of their wrist pain at rest and during movement, and the mean grip strength increased from 37% of that in the contralateral hand before surgery to 80% after surgery. The mean post-operative range of motion in the affected wrist was 92% of that in the opposite wrist in patients with stage 1 and 2 disease, and 53% in patients with stage 3 disease. Post-operative assessment revealed that four patients had excellent results, three had good results, and one had a fair result.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, 54 Shougoin Kawahara-cho, Sakyo-ku 606-8507, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kakinoki
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: T
authors.initials: T
authors.lastname: Suzuki
authors.forename: N
authors.initials: N
authors.lastname: Funakoshi
authors.forename: T
authors.initials: T
authors.lastname: Okamoto
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D002348:Carpal Bones / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012667:Lunate Bone / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010007:Osteochondritis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D011859:Radiography; D011884:Radius / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012720:Severity of Illness Index; D013524:Surgical Flaps / Q000098:blood supply* / Q000502:physiology; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*