title: Tendon interposition and ligament reconstruction with ECRL tendon in the late stages of Kienböck's disease: a cadaver study.
abstract: BACKGROUND
  The optimal surgical treatment for Kienböck's disease with stages IIIB and IV remains controversial. A cadaver study was carried out to evaluate the use of coiled extensor carpi radialis longus tendon for tendon interposition and a strip obtained from the same tendon for ligament reconstruction in the late stages of Kienböck's disease.
  
  
  METHODS
  Coiled extensor carpi radialis longus tendon was used to fill the cavity of the excised lunate, and a strip obtained from this tendon was sutured onto itself after passing through the scaphoid and the triquetrum acting as a ligament to preserve proximal row integrity. Biomechanical tests were carried out in order to evaluate this new ligamentous reconstruction.
  
  
  RESULTS
  It was biomechanically confirmed that the procedure was effective against axial compression and distributed the upcoming mechanical stress to the distal row.
  
  
  CONCLUSIONS
  Extensor carpi radialis longus tendon has not been used for tendon interposition and ligament reconstruction in the treatment of this disease before. In view of the biomechanical data, the procedure seems to be effective for the stabilization of scaphoid and carpal bones.
authors.affiliation: Department of Orthopaedics and Traumatology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Nazım
authors.initials: N
authors.lastname: Karalezli
authors.forename: Aysun
authors.initials: A
authors.lastname: Uz
authors.forename: Ali Fırat
authors.initials: AF
authors.lastname: Esmer
authors.forename: Mehmet
authors.initials: M
authors.lastname: Demirtaş
authors.forename: Arzu Gül
authors.initials: AG
authors.lastname: Taşcı
authors.forename: Harun
authors.initials: H
authors.lastname: Kütahya
authors.forename: Gürhan
authors.initials: G
authors.lastname: Ulusoy
mesh_terms: D002102:Cadaver; D006801:Humans; D010020:Osteonecrosis / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013709:Tendon Transfer / Q000379:methods*; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome; D014955:Wrist Joint / Q000601:surgery*