Pronator quadratus pedicled bone graft in the treatment of Kienböck disease: follow-up 2 to 12 years

We inserted a pronator quadratus pedicled bone graft into the avascular lunate with preservation of its corticocartilaginous portion for the treatment of Kienböck disease. Twenty-seven patients (14 men, 13 women; mean age, 42 years (range 17–66 years)) were treated between September 2005 and July 20...

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Bibliographic Details
Published in:The Journal of hand surgery, European volume European volume, 2020-05, Vol.45 (4), p.396-402
Main Authors: Shin, Young Ho, Yoon, Jun O, Ryu, Jae Jung, Lee, Tae Kyoon, Choi, Shin Woo, Kim, Jae Kwang
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Bone Transplantation
Female
Follow-Up Studies
Humans
Lunate Bone - diagnostic imaging
Lunate Bone - surgery
Male
Middle Aged
Osteonecrosis - diagnostic imaging
Osteonecrosis - surgery
Wrist Joint - diagnostic imaging
Wrist Joint - surgery
Young Adult
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Summary:We inserted a pronator quadratus pedicled bone graft into the avascular lunate with preservation of its corticocartilaginous portion for the treatment of Kienböck disease. Twenty-seven patients (14 men, 13 women; mean age, 42 years (range 17–66 years)) were treated between September 2005 and July 2014 and followed up from 2 to 12 years. Three patients had Lichtman stage II disease, 13 had stage IIIA, and 11 had stage IIIB. Among them, 18 patients showed radiological improvement in lunate morphology. The Lichtman stage was unchanged in 23 patients and aggravated in four patients. The Stahl index was significantly decreased, but grip strength was significantly improved and 18 patients did not have any wrist pain during daily activities. Although our technique did not restore the already changed carpal malalignment, it improved lunate morphology. Clinically, it provided satisfactory pain levels in two-thirds of the patients and grip strength was improved. Level of evidence: IV
ISSN:1753-1934
2043-6289
DOI:10.1177/1753193419836628