Lunate Excision, Capitate Osteotomy, and Intercarpal Arthrodesis for Advanced Kienböck Disease

Takase, Katsumi; Imakiire, Atsuhiro
February 2001
Journal of Bone & Joint Surgery, American Volume;Feb2001, Vol. 83-A Issue 2, p177
Academic Journal
Background: Kienböck disease is caused by aseptic necrosis of the lunate. In the advanced stages of the disease, carpal collapse, joint incongruity, and osteoarthritis develop. We performed lunate excision, capitate osteotomy, and intercarpal arthrodesis (the modified procedure of Graner et al.) on fifteen patients with stage-IIIB or IV Kienböck disease. This report is a review of the findings in these patients. Methods: The subjects ranged in age from twenty-six to fifty-four years (mean, 39.2 years) at the time of surgery. We evaluated the results more than five years postoperatively (range, sixty-two to 145 months postoperatively; mean, 79.3 months postoperatively). Therapeutic results were evaluated according to the scoring system of Evans et al. Results: Pain disappeared after surgery in most patients. Others had a reduction in the intensity of the pain to a mild level. The grip strength on the affected side had recovered to about 80% of that on the unaffected side twelve months after surgery. The long-term results were graded as good in eleven of the patients, as fair in two, and as poor in two. Postoperative radiographs showed that the carpal bone parameters (carpal height index and radioscaphoid angle) had improved. Radiographic osteoarthritic changes occurred in all of the patients; however, except for moderate limitation of the range of motion at the wrist joint, these findings did not affect the level of pain, grip strength, or activities of daily living. Conclusions: Lunate excision followed by capitate osteotomy and intercarpal arthrodesis (the modified procedure of Graner et al.) is a reliable form of treatment for advanced Kienböck disease, with favorable results for at least five years postoperatively.


Related Articles

  • Bilateral Polydactyly in a foal. Carstanjen, Bianca; Abitbol, Marie; Desbois, Christophe // Journal of Veterinary Science;2007, Vol. 8 Issue 2, p201 

    The following case report describes the diagnosis and surgery of bilateral polydactyly of unknown origin in a colt. A 7-month-old Berber colt was referred for cosmetic and curative excision of supernumerary digits. Radiographic examination revealed bilateral polydactyly and welldeveloped first...

  • metacarpectomy.  // Taber's Cyclopedic Medical Dictionary;2005, p1349 

    A definition of the term "metacarpectomy" is presented. It refers to the surgical excision or resection of one or more metacarpal bones. The definition is from the "Taber's Cyclopedic Medical Dictionary," published by F.A. Davis Co.

  • Ulnocarpal impaction syndrome: treatment with a transverse ulnar shortening osteotomy from an ulnodorsal approach. Lautenbach, Martin; Millrose, Michael; Schmidt, Nicole-Simone; Zach, Alexander; Eichenauer, Frank; Eisenschenk, Andreas // Archives of Orthopaedic & Trauma Surgery;Jun2014, Vol. 134 Issue 6, p881 

    Introduction: Ulnocarpal impaction syndrome is a common cause of chronic ulnar-sided wrist pain. The distal ulnar shortening osteotomy addresses the often present positive ulnar variance and therefore relieves the excessive load on the ulnocarpal joint. In the present study, the results of a...

  • Surgical Technique: Extraarticular Knee Resection with Prosthesis-Proximal Tibia-extensor Apparatus Allograft for Tumors Invading the Knee. Capanna, Rodolfo; Scoccianti, Guido; Campanacci, Domenico; Beltrami, Giovanni; Biase, Pietro // Clinical Orthopaedics & Related Research;Oct2011, Vol. 469 Issue 10, p2905 

    Background: Intraarticular extension of a tumor requires a conventional extraarticular resection with en bloc removal of the entire knee, including extensor apparatus. Knee arthrodesis usually has been performed as a reconstruction. To avoid the functional loss derived from the resection of the...

  • New Concepts in Limb Salvage. Jolly, Gary Peter; Zgonis, Thomas // Podiatry Management;Nov/Dec2004, Vol. 23 Issue 9, p101 

    Discusses various strategies in the treatment of the chronic foot wounds of several diabetic patients. Tibio-calcaneal and a calcaneocuboid arthrodeses to deal with osteolysis of the histalus and navicular; Adipofascial sural artery flap and skin graft to close a heel ulcer; Reconstruction of...

  • Short-term followup after surgical treatment of Ewing's sarcoma. Rastogi, Shishir; Kumar, Ashok; Gupta, Himanshu; Khan, Shah Alam; Bakhshi, Sameer // Indian Journal of Orthopaedics;Oct-Dec2010, Vol. 44 Issue 4, p384 

    Background: Results of surgical treatment in Indian patients of Ewing's sarcoma managed with multimodality treatment with chemotherapy and/or radiotherapy are insufficient. We report a retrospective evaluation of a series of cases of Ewing's sarcoma managed with chemotherapy, surgery with or...

  • Salvage of the Failed Keller Resection Arthroplasty. Machacek Jr., Felix; Easley, Mark E.; Gruber, Florian; Ritschl, Peter; Trnka, Hans-Jörg // Journal of Bone & Joint Surgery, American Volume;Mar2005 Supplement 1, Vol. 87-A, p86 

    BACKGROUND: A number of typical complications have been associated with Keller resection arthroplasty. Recurrent valgus deformity, cock-up deformity, and a flail toe may be difficult problems for the treating surgeon because options for salvage are limited. In this study, we evaluated...

  • Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius. Mays, Chester J.; Ver Steeg, Kyle; Chowdhry, Saeed; Seligson, David; Wilhelmi, Bradon J. // ePlasty: Open Access Journal of Plastic Surgery;2010, Vol. 10, p313 

    Objective: Multiple therapeutic modalities exist for giant cell tumors (GCT) in the distal radius. The majority of GCTs are amenable to curettage, with the expanded lesions requiring a more radical approach. This case report examines the technique of managing a GCT that has extended beyond the...

  • Resection arthrodesis for giant cell tumors around the knee. Kapoor, Sudhir K.; Tiwari, Akshay // Indian Journal of Orthopaedics;Apr-Jun2007, Vol. 41 Issue 2, p124 

    Background: Giant cell tumors (GCTs) of bone are aggressive benign tumors. Wide resection is reserved for a small subset of patients with biologically more aggressive, recurrent and extensive tumors. As the patients affected with GCT are young or middle-aged adults with a normal life expectancy,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics