Radiolunate fusion using vascularized radius bridging graft for the treatment of advanced Kienböck disease: two cases report.
We present here two cases wherein we performed radiolunate fusion using vascularized radius graft with the vascular pedicle of the fourth extensor compartment artery (fourth ECA) for the treatment of Bain's grade 2A Kienböck disease with incongruity of the radiolunate joint. The dorsodistal radius graft was levered out and mobilized on the pedicle of the fourth ECA; then the vascularized dorsodistal radius was shifted 1 cm distally and bridges were created between the radius and the lunate. The radiolunate joint was completely fused in both cases at three months after surgery. The capitolunate joint maintained congruity after surgery. The Mayo wrist score was 75 points, and the DASH (JSSH version) score for the two cases was 2.5 and 4.2 points, respectively. Radiolunate fusion using the vascularized radius bridging procedure is one of the satisfactory methods for treating advanced Kienböck disease, especially in Bain's grade 2A cases.
Ono
H
H
Department of Orthopaedic Surgery, Kokuho Central Hospital, 404-1 Miyako, Tawaramoto, Shiki-gun, Nara 636-0302, Japan. onokota@kinet-tv.ne.jp
Furuta
K
K
Fujitani
R
R
D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D006801:Humans; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery*