The Dorsal Flap Arthroplasty in the Treatment of Kienböckʼs Disease

Silicone implant arthroplasty in Kienböck's disease

“…Many authors disregard trauma in the etiology of malacia of the h a t e (Hultkn 1928, Persson 1950, Antuna-Zapico 1981. A step formation at the distal radioulnar joint in connection with ulnaminus variance may be an etiologic factor of malacia of the lunate (Miiller 1920,'HultCn 1928, Persson 1950, Marek 1957, Nahigian et al 1970). …”

“…Good results have been reported by excising the h a t e (Dornan 1949, Marek 1957, Einola et al 1979, Gillespie 1961, but this treatment has also been criticized (Stbhl 1947, Therkelsen & Andersen 1949, Persson 1950. A dorsal flap (Nahigian et al 1970) or tendon interposition arthroplasty (Ueba et al 1972, Ishiguro et al 1978, Hastings et al 1983) has tended to diminish carpal collapse. Danis (1951), Agerholm & Goodfellow (1963, Renard et al (1970), Aderhold & Aderhold (1972), and Barber & Goodfellow (1974) used an acrylic prosthesis.…”

Radial osteotomy for late-stage Kienböck's disease

“…The aetiology of Kienböck's disease, or lunate malacia, remains unclear. Treatment includes conservative measures and surgical procedures such as excision arthroplasty, [1][2][3] radial osteotomy (shortening and wedge resection), [4][5][6][7][8][9][10] limited intercarpal fusions, [11][12][13][14] and vascularised bone grafting. 15 Hulten 16 recognised that there was a positive correlation between Kienböck's disease and negative ulnar variance.…”

Transfert du pisiforme vascularisé à la place du lunatum dans la maladie de Kienböck

“…Elle a été suivie par une prothèse métallique. Les complications étaient nombreuses : luxations, synovite ou usure, et ont abouti à son abandon ; le remplacement du lunatum par un lambeau capsulaire (1970) [12] ou par une tendon-ball : un tendon enroulé sur elle-même (1999) [13] ; le remplacement du lunatum par le pisiforme pédiculé (1985) que nous proposons ici.…”