Abstract
References
- Keith PP, Nuttall D, Trail I. Long-term outcome of nonsurgically managed Kienböck’s disease. The Journal of hand surgery. 2004;29(1):63-7.
- Kakar S, Shin A. Vascularized bone grafting from the dorsal distal radius for Kienböck's disease: technique, indications and review of the literature. Chirurgie de la main. 2010;29:S104-S11.
- Wagner JP, Chung KCJTJohs. A historical report on Robert Kienböck (1871–1953) and Kienböck’s disease. 2005;30(6):1117-21.
- Gelderman R, Salamon P, Jurist J, Posch J. Ulnar variance in Kienbock's disease. J Bone Joint Surg[Am]. 1975;57:674.
- Lichtman DM, Degnan GG. Staging and its use in the determination of treatment modalities for Kienböck's disease. Hand clinics. 1993;9(3):409-16.
- GELBERMAN RH, GROSS MSJCO, Research R. The Vascularity of the Wrist: Identification of Arterial Patterns at Risk. 1986;202:40-9.
- Özden E, Özçelik İB. Comparison of Clinical Outcomes in Open and Arthroscopically-assisted Mini Open Proximal Row Carpectomy for Lichtman Stage IIIB and IIIC Kienböck Disease. The Journal of Hand Surgery. 2022.
- de Villeneuve Bargemon J-B, Peras M, Hasegawa H, Levadoux M. Arthroscopic Scaphocapitate Fusion: Surgical Technique. Arthroscopy Techniques. 2022;11(7):e1289-e94.
- Rodríguez-Nogué L, Martínez-Villén G. Results of the total wrist arthrodesis with contoured plate in a series of 41 wrists with median follow-up of 6 years. Acta Orthopædica Belgica. 2022;88:636-41.
- Woo S-H, Kim S-M, Ahn Y-S, Hyun J-H, Kim H-Y, Kim M-S. Combined radial wedge and shortening osteotomy versus scaphocapitate arthrodesis in advanced Kienböck’s disease. Acta Orthopædica Belgica. 2022;88:739-47.
- Matsui Y. Surgical Treatments: Capitate Shortening Osteotomy. Introduction to Kienböck’s Disease: Basic Science, Diagnosis and Treatment: Springer; 2023. p. 97-102.
- Park I-J, Kim H-M, Lee J-Y, Roh Y-T, Kim D-Y, Jeon N-H, et al. Treatment of Kienböck's disease using a fourth extensor compartmental artery as a vascularized pedicle bone graft. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2016;69(10):1403-10.
- Tsantes AG, Papadopoulos DV, Gelalis ID, Vekris MD, Pakos EE, Korompilias AVJJoh, et al. The efficacy of vascularized bone grafts in the treatment of scaphoid nonunions and Kienbock disease: a systematic review in 917 patients. 2019;11(01):006-13.
- Ye X, Feng J-T, Yin H-W, Qiu Y-Q, Shen Y-D, Xu W-DJHS, et al. Use of 4+ 5 extensor compartmental vascularized bone graft and K-wire fixation for treating stage II-IIIA Kienböck's disease. 2020;39(3):207-13.
- Moran SL, Cooney WP, Berger RA, Bishop AT, Shin AYJTJohs. The use of the 4+ 5 extensor compartmental vascularized bone graft for the treatment of Kienböck’s disease. 2005;30(1):50-8.
- CHUNG U-S, KIM K-C, LEE K-HJJotKSfSotH. 4+ 5 Extensor Compartmental Vascularized Bone Graft for Stage III Kienbock's Disease: Preliminary Results. 2009:6-11.
The Efficacy of Surgical Treatment for Kienböck’s Disease with 4-5 ECA Pedicled Osseous Flap: A Retrospective Study
Abstract
Aim: The aim of this retrospective study is to assess the effectiveness of surgical intervention for Kienböck's disease using 4-5 Extensor Compartmental Artery (4-5 ECA) pedicled osseous flap
Method: Patients who underwent 4-5 ECA pedicled bone grafts for Kienböck's disease between January 2012 and January 2022 were included in the study. The patient files were analyzed retrospectively for age, gender, follow-up time, and complications. Disease staging was performed preoperatively using direct X-ray and MRI, and radiological improvement was evaluated postoperatively using radiography. The functional and clinical assessment was made by comparing preoperative and postoperative VAS, Q-Dash, and Mayo scores.
Results: This study involved 23 patients (12 female and 11 male) with Kienböck's disease who underwent 4-5 ECA pedicled bone graft surgery. 13 cases were right-handed while 10 were left-handed. The mean age was 37.5 ± 12.5 years, and the mean follow-up time was 68 months. The mean preoperative Q-Dash score was 78.8 (± 9), the VAS score was 6.5 (±1.2, and the Mayo wrist score was 34.34 (±11.8). The mean postoperative Q-Dash score was 33.1( ±10), the VAS score was 2.4 (±1.7), and the Mayo wrist score was 73.9 (±14.5). The differences between preoperative and postoperative Q-DASH scores (p<0.05), VAS scores (p<0.05), and Mayo wrist scores (p<0.05) were statistically significantly improved. Disease progression was observed in only two patients based on the Lichtman Classification in their follow-up radiographs.
Conclusion: Our study demonstrates that the surgical treatment of Kienböck's disease using a 4-5 ECA pedicled osseous flap is a reliable and effective surgical treatment option.
References
- Keith PP, Nuttall D, Trail I. Long-term outcome of nonsurgically managed Kienböck’s disease. The Journal of hand surgery. 2004;29(1):63-7.
- Kakar S, Shin A. Vascularized bone grafting from the dorsal distal radius for Kienböck's disease: technique, indications and review of the literature. Chirurgie de la main. 2010;29:S104-S11.
- Wagner JP, Chung KCJTJohs. A historical report on Robert Kienböck (1871–1953) and Kienböck’s disease. 2005;30(6):1117-21.
- Gelderman R, Salamon P, Jurist J, Posch J. Ulnar variance in Kienbock's disease. J Bone Joint Surg[Am]. 1975;57:674.
- Lichtman DM, Degnan GG. Staging and its use in the determination of treatment modalities for Kienböck's disease. Hand clinics. 1993;9(3):409-16.
- GELBERMAN RH, GROSS MSJCO, Research R. The Vascularity of the Wrist: Identification of Arterial Patterns at Risk. 1986;202:40-9.
- Özden E, Özçelik İB. Comparison of Clinical Outcomes in Open and Arthroscopically-assisted Mini Open Proximal Row Carpectomy for Lichtman Stage IIIB and IIIC Kienböck Disease. The Journal of Hand Surgery. 2022.
- de Villeneuve Bargemon J-B, Peras M, Hasegawa H, Levadoux M. Arthroscopic Scaphocapitate Fusion: Surgical Technique. Arthroscopy Techniques. 2022;11(7):e1289-e94.
- Rodríguez-Nogué L, Martínez-Villén G. Results of the total wrist arthrodesis with contoured plate in a series of 41 wrists with median follow-up of 6 years. Acta Orthopædica Belgica. 2022;88:636-41.
- Woo S-H, Kim S-M, Ahn Y-S, Hyun J-H, Kim H-Y, Kim M-S. Combined radial wedge and shortening osteotomy versus scaphocapitate arthrodesis in advanced Kienböck’s disease. Acta Orthopædica Belgica. 2022;88:739-47.
- Matsui Y. Surgical Treatments: Capitate Shortening Osteotomy. Introduction to Kienböck’s Disease: Basic Science, Diagnosis and Treatment: Springer; 2023. p. 97-102.
- Park I-J, Kim H-M, Lee J-Y, Roh Y-T, Kim D-Y, Jeon N-H, et al. Treatment of Kienböck's disease using a fourth extensor compartmental artery as a vascularized pedicle bone graft. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2016;69(10):1403-10.
- Tsantes AG, Papadopoulos DV, Gelalis ID, Vekris MD, Pakos EE, Korompilias AVJJoh, et al. The efficacy of vascularized bone grafts in the treatment of scaphoid nonunions and Kienbock disease: a systematic review in 917 patients. 2019;11(01):006-13.
- Ye X, Feng J-T, Yin H-W, Qiu Y-Q, Shen Y-D, Xu W-DJHS, et al. Use of 4+ 5 extensor compartmental vascularized bone graft and K-wire fixation for treating stage II-IIIA Kienböck's disease. 2020;39(3):207-13.
- Moran SL, Cooney WP, Berger RA, Bishop AT, Shin AYJTJohs. The use of the 4+ 5 extensor compartmental vascularized bone graft for the treatment of Kienböck’s disease. 2005;30(1):50-8.
- CHUNG U-S, KIM K-C, LEE K-HJJotKSfSotH. 4+ 5 Extensor Compartmental Vascularized Bone Graft for Stage III Kienbock's Disease: Preliminary Results. 2009:6-11.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original Article |
| Authors | |
| Early Pub Date | August 29, 2023 |
| Publication Date | August 31, 2023 |
| Submission Date | April 26, 2023 |
| Published in Issue | Year 2023 Volume: 33 Issue: 4 |
Journal of General Medicine is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).