Osteonecrosis of the Lunate: Kienböck Disease

Rioux-Forker, Dana; Shin, Alexander Y.

doi:10.5435/jaaos-d-20-00020

Cited by 25 publications

(20 citation statements)

References 38 publications

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“…Stage 4 Kienbock's disease can be treated with Wrist fusion, Proximal row carpectomy and limital carpal fusion [1] . The rationale for treatment of SC Arthrodesis concurs with the concept of Scaphotrapeziotrapezoid (STT) arthrodesis popularized by Watson et al [7,8] . Both STT and SC Arthrodesis aims to stop progression of carpal collapse and carpal-ulnar translation in order to preserve functional motion and provide pain relief [9] .…”

Section: Discussionmentioning

confidence: 81%

A case report of lunate excision with scapho-capitate arthrodesis in Kienbock’s disease

Vaishnav¹,

Desai²,

Patel³

et al. 2021

Nat. J. Clin. Orthop.

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Case study of a 22-year female presented to our clinic with complaints of dorsal wrist pain, swelling and stiffness with decreased motion at left wrist joint with a duration of 2 months without any significant traumatic history. On evaluation dorsal wrist pain and point tenderness over lunate bone was present. Radiographs and Advanced imaging MRI was suggestive of Kienbock's disease. This was treated with Lunate excision and scapho-capitate arthrodesis along with bone grafting. Advanced stages of Kienbock's are usually managed by Wrist fusion or proximal row carpectomy. We are reporting our result of scapho-capitate arthrodesis which was performed to stop progression of carpal collapse and carpal-ulnar translation and thereby preserve functional motion and provide pain relief.

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Section: Discussionmentioning

confidence: 81%

A case report of lunate excision with scapho-capitate arthrodesis in Kienbock’s disease

Vaishnav¹,

Desai²,

Patel³

et al. 2021

Nat. J. Clin. Orthop.

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“…Çoğu hasta travma öyküsü olmaksızın sinsi, ilerleyici ağrı tanımlar. [26] Kienböck hastalığının tanısında MR görüntüleme altın standarttır. Radyografilerin normal olduğu erken…”

Section: Hamatum Kırıklarıunclassified

“…Hastalığın evresine göre kor dekompresyon, radyal kısaltma, kapitat kısaltma, damarlı greftle revaskülarizasyon, proksimal sıra karpektomi, kısmi ya da total el bilek artrodezi gibi cerrahi seçenekler mevcuttur. [26]…”

Section: Tendon Kılıfının Dev Hücreli Tümörüunclassified

El bileğinin distal radyoulnar eklem dışı sorunları

Şahin¹,

Sargın²,

Gökkuş³

2021

TOTBID

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Ulna kemiğinin distalinde ekstansör karpi ulnaris (EKU) sürtünmeye karşı sinovyal bir membranla korunarak fibro-osseöz bir tünel olan 6. ekstansör kompartmandan geçer. EKU tendonuna stabilite sağlamak için 6. ekstansör kompartman, kalın periostla döşeli bir oluk olan ulnar sulkusun üstünü örter. Ulnotrikuetral eklem aralığı seviyesinde EKU kılıfı sonlanır. Bu seviyeden itibaren EKU tendonu ekstansör retinakulum tarafından örtülür (Şekil 1). [1]

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“…steonecrosis of the lunate, known as Kienböck's disease, is a rare and debilitating condition with poorly understood etiology [1][2][3]. Repetitive microtrauma is referred to as the major extrinsic risk factor of Kienböck's disease [4,5]; such characteristics as a shortened ulna, lower number of arteries, reduced radial inclination angle, and type I lunate morphology are the intrinsic risk factors of this disorder [4,6].…”

Section: Introductionmentioning

confidence: 99%

“…Besides, the decision for surgical intervention is generally based on the presence of this measure [7][8][9]. Several methods are introduced for this measurement, including the Carpal Height Ratio (CHR) [1,2], Revised Carpal Height Ratio (RCHR) [3], and the Capitate-Radius (CR) index [4]. All methods were described as reliable by the original authors; however, identifying the most reliable approach for carpal collapse evaluation is necessary.…”

Section: Introductionmentioning

confidence: 99%

The Inter- and Intra-observer Reliability of Three Methods for Evaluating Carpal Collapse

Shariatzade

Saied

Barkam

et al. 2021

J. Res. Orthop. Sci.

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Background: Kienbock’s disease is a rare and debilitating condition. The decision for surgical intervention majorly depends on the extent of the carpal collapse. Therefore, the accurate measurement of carpal collapse is of critical importance. Objectives: The current study assessed the inter and intra-observer reliability of the three most frequent methods in measuring carpal height and determining carpal collapse. Methods: Fifty-Nine photocopied radiograms were reviewed by three observers (one senior orthopedic resident, one fellowship-trained hand surgeon, and one senior radiology resident) at 3 consecutive time points. Besides, one-week intervals were considered between the evaluations. The evaluated measures included the Carpal Height Ratio (CHR), Revised Carpal Height Ratio (RCHR), and Capitate-Radius (CR) index. The reliability of the measurements in determining the carpal height was examined using the Intraclass Correlation Coefficient (ICC). The agreement of the measures on determining the presence or absence of the carpal collapse was assessed by Cohen’s Kappa (K) value. Results: The overall inter and intra-observer reliability of the CR index in quantifying the carpal collapse was measured as 0.863 and 0.942, respectively. The overall inter and intra-observer reliability of CHR in quantifying the carpal collapse was computed to be 0.615 and 0.891, respectively. The overall inter and intra-observer reliability of RCHR in quantifying the carpal collapse equaled 0.412 and 0.792, respectively. The overall K for determining the presence or absence of a carpal collapse was calculated as 0.776, 0.683, and 0.549 for CR index, CHR, and RCHR, respectively. Conclusion: The CR index is the most reliable approach to measure carpal height. Furthermore, it is appropriate for determining the presence or absence of carpal collapse.

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Osteonecrosis of the Lunate: Kienböck Disease

Abstract: Kienböck disease, osteonecrosis of the lunate, is a well-known but poorly understood complication seen by hand surgeons. This review presents the background and important patient-specific parameters of the disease and reviews the numerous treatment options that exist for the disease.

Cited by 25 publications

References 38 publications

A case report of lunate excision with scapho-capitate arthrodesis in Kienbock’s disease

A case report of lunate excision with scapho-capitate arthrodesis in Kienbock’s disease

El bileğinin distal radyoulnar eklem dışı sorunları

The Inter- and Intra-observer Reliability of Three Methods for Evaluating Carpal Collapse

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