Foreign-Body Reaction and Osteolysis in Dorsal Lunate Dislocation Repair With Bioabsorbable Suture Anchor

Zaidenberg, Ezequiel Ernesto; Roitman, Pablo; Gallucci, Gerardo; Boretto, Jorge G.

doi:10.1177/1558944715627632

Cited by 7 publications

(11 citation statements)

References 18 publications

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“…This may lead to bone weakness during the degradation phase [35][36][37]. Complications arising from the use of bioabsorbable polymers include foreign matter reaction, osteolysis, synovitis, cartilage defects or local pain [38][39][40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

Pastl¹,

Schimetta

2021

Arch Orthop Trauma Surg

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Introduction The allogeneic bone screw transplant is a new osteosynthesis device making the use of foreign fixation material obsolete for various kinds of indications. Moreover, it is integrated into the recipient bone by natural bone remodeling without harming the surrounding tissue. The aim of this study was to determine the efficacy and safety of the transplant for osteotomy and arthrodesis in hand and foot surgery and to evaluate the clinical importance of the device. Materials and methods A single-surgeon case series of 32 patients who had undergone hand or foot surgery with the application of an allogeneic bone screw with an average follow-up time of 1 year is reported. Clinical data were reviewed to evaluate the pain levels and satisfaction of the patients and the frequency and type of complications occurring during the healing process. Routine radiography and computed tomography were reviewed to determine the fusion rate, the ingrowth behavior of the transplant and the possible occurrence of transplant failure. Results High patient satisfaction was paired with low postoperative pain levels and a low complication rate. 97% of the patients were free of pain at the timepoint of the second follow-up examination, the mean time of recovery of full mobility was 50.1 ± 26.1 days after surgery. Wound healing disturbance occurred only in two cases. Bony consolidation of the osteotomy or arthrodesis gap as well as osseointegration of the transplant was seen in all cases. No transplant failure or transplant loosening occurred. Conclusions The application of the allogeneic bone screw resulted in a 100% fusion rate while the patient burden was low. The transplant is safe and suited for various kinds of osteosynthesis in hand and foot surgery.

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Section: Discussionmentioning

confidence: 99%

The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

Pastl¹,

Schimetta

2021

Arch Orthop Trauma Surg

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“…5 On the contrary, AVN of the lunate is a major concern after dorsal LD. In a cumulative data of 14 patients with dorsal LD and its variants collected from English literature and the current case (►Table 1), 5 patients developed AVN, 2,5,6,13 1 patient was treated with excision of the lunate because of delayed treatment, 10 1 patient was treated with limited arthrodesis to enhance revascularization of the lunate, 3 2 patients were treated with proximal row carpectomy, 8,9 1 patient was lost to follow-up, 7 and 2 patients had only a few months of follow-ups that were insufficient to verify about development of AVN of the lunate. 11,12 AVN was not reported in two patients.…”

Section: Discussionmentioning

confidence: 99%

“…1 There are limited case reports describing dorsal LD and its variants in the literature. [2][3][4][5][6][7][8][9][10][11][12][13] The current case report describes a case of transscaphoid dorsal LD.…”

Section: Introductionmentioning

confidence: 99%

Transscaphoid Dorsal Lunate Dislocation: A Case Presentation and Review of the Literature

Afshar

Tabrizi

Aidenlou

2021

Journal of Hand and Microsurgery

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This case report describes a 74-year-old man with the rare injury of transscaphoid dorsal lunate dislocation (LD). He sustained a crushing injury with a huge amount of energy to his right wrist while working with a pressing machine. There were deep abrasions and areas of skin necrosis on the dorsum of the wrist. The patient was treated with closed reduction and a Herbert screw fixation for the scaphoid fracture. Six months postoperatively, avascular necrosis (AVN) of the lunate and scaphoid was apparent on the wrist radiographs. We offered a proximal row carpectomy to the patient, but he declined surgery because he was able to perform his activity of daily living. Dorsal LD as well as its variants has a high prevalence of AVN of the lunate. Delayed diagnosis, delayed treatment, and open reduction increase the risk of AVN development of the lunate. The level of evidence is therapeutic IV.

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“…The focus of treatment for lunate dislocation is long-term preservation of the appropriate postreduction scapholunate position, because 60% of the stress to the distal carpal row is transmitted through the scaphoid-capitate joint. [28] Earlier, to ensure this, the main treatment approach was to repair the perilunate ligament and joint capsule, followed by temporary Kirschner wire fixation of the scaphoid-lunate-capitate [3–5] or scaphoid-lunate-triquetrum. [6,7] However, a simple first-stage scapholunate fixation was ineffective, as patients were prone to develop scapholunate separation and progressive carpal collapse during long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…[2] To date, there is no consensus regarding the optimal treatment of lunate dislocations. Traditional treatments mainly include reduction of the lunate, repair of the surrounding ligaments and joint capsules, and Kirschner wire or screw fixation of the scaphoid-lunate-capitate [3–5] or scaphoid-lunate-triquetrum. [6,7] However, complications are frequent and often yield unsatisfactory results; scapholunate separation and carpal bone collapse often occur, and a secondary operation for the removal of the proximal carpal row is required, resulting in disability and teratogenicity.…”

Section: Introductionmentioning

confidence: 99%

First-stage scapholunate fusion for the treatment of a chronic lunate dislocation

et al. 2019

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Rationale: Lunate dislocation is a rare injury to the wrist caused by high-energy trauma, and poor prognosis is often associated with missed initial diagnosis. To date, there is no consensus regarding an effective treatment plan for such cases. Patient concerns: Here, we describe the case of a 36-year-old man who presented with lunate dislocation following a delay in diagnosis of over 7 weeks, and further illuminate its diagnosis and treatment. Diagnosis: The diagnosis of chronic lunate dislocation was rendered. Interventions: The patient was treated using reduction via the dorsal approach brachial plexus anesthesia. After the reduction, a headless compression screw fixation was performed for first-stage scapholunate fusion, and Kirschner wire fixation of the lunate-triquetrum-hamate was used to stabilize the distal and proximal carpal rows. Outcomes: The patient was followed up for 1 year and showed wrist function recovered well; radiographic examination showed no lunate dislocation and successful scapholunate bony fusion. A satisfactory outcome was achieved. Lessons: The case study presented here provide evidence that performing an effective first-stage scapholunate fusion is recommended to achieve better therapeutic outcomes for a chronic lunate dislocation. Furthermore, this approach led to a good long-term clinical outcome in our case.

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Foreign-Body Reaction and Osteolysis in Dorsal Lunate Dislocation Repair With Bioabsorbable Suture Anchor

Cited by 7 publications

References 18 publications

The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series

Transscaphoid Dorsal Lunate Dislocation: A Case Presentation and Review of the Literature

First-stage scapholunate fusion for the treatment of a chronic lunate dislocation

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