title: Long-term results of vascularized bone graft for stage III Kienböck disease.
abstract: OBJECTIVE
  Vascularized bone grafting (VBG) is one of the therapeutic approaches for treating advanced Kienböck disease; however, few reports on long-term outcomes are available for this technique. The purpose of this study is to evaluate long-term results by following up patients with stage III Kienböck disease for more than 10 years after VBG.
  
  
  METHODS
  The study included 18 patients with advanced Kienböck disease (Lichtman stage IIIA, n = 10; stage IIIB, n = 8) who received VBG between 1996 and 2001 and were followed up for at least 10 years. Eleven patients received transplantation from the metacarpal base and 7 patients from the distal radius. Radial shortening and capitate shortening were performed in 5 and 2 stage IIIB patients, respectively.
  
  
  RESULTS
  The mean follow-up period was 12 years, 3 months. Based on the Mayo Modified Wrist Score, clinical results were excellent in 8 patients, good in 7 patients, and fair in 3 patients. The Stahl index and carpal height ratio were not improved in stage IIIA patients who received bone graft alone, whereas significant improvement was observed in stage IIIB patients who received shortening, as well.
  
  
  CONCLUSIONS
  Vascularized bone grafting for stage III Kienböck disease demonstrated favorable long-term results and is recommended as a surgical treatment.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Department of Orthopaedics, Kyoto Prefectural University of Medicine, Kyoto, Japan. fjwr@koto.kpu-m.ac.jp
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Ryo
authors.initials: R
authors.lastname: Oda
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Morisaki
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ikoma
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kubo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D018737:Hand Strength; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000503:physiopathology* / Q000601:surgery*; D010027:Osteotomy; D011884:Radius / Q000601:surgery; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology*; D055815:Young Adult