title: Stage 3 Kienböck's disease: reconstruction of the fractured lunate using a free vascularized iliac bone graft and external fixation.
abstract: 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 was stabilized with an external fixator during healing. The efficiency of the procedure for restoring the structure of the fractured lunate, preventing carpal collapse and improving the clinical outcome was assessed at a mean follow-up of 5 years. The graft became incorporated in the lunate in 16 of the 18 patients and no fracture of the reconstructed lunate or carpal collapse occurred in these cases. The graft did not integrate and was resorbed in the other two patients.
authors.affiliation: University Hospital of Traumatology, Innsbruck, Austria. m.gabl@uibk.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Gabl
authors.forename: M
authors.initials: M
authors.lastname: Lutz
authors.forename: Cl
authors.initials: C
authors.lastname: Reinhart
authors.forename: R
authors.initials: R
authors.lastname: Zimmerman
authors.forename: S
authors.initials: S
authors.lastname: Pechlaner
authors.forename: H
authors.initials: H
authors.lastname: Hussl
authors.forename: M
authors.initials: M
authors.lastname: Rieger
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000098:blood supply / Q000503:physiopathology / Q000637:transplantation*; D012667:Lunate Bone / Q000098:blood supply / Q000293:injuries* / Q000601:surgery*; D008297:Male; D010020:Osteonecrosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D013997:Time Factors