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

Saffar, P.

doi:10.1016/j.main.2010.09.005

Cited by 19 publications

(3 citation statements)

References 6 publications

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“…[18] Furthermore, stage IIIb-IV Kienböck disease is characterized by scaphoid malalignment and rotation, which result in uneven stress distribution of the pisiform bone as well as greater pressure. In a study by Daecke et al, [19] the necessity of combined carpal fusion was proposed to be controversial in the “Saffar's Procedure.” Further studies [20,21] showed that either fusion type (STT or SC) used in combination reduces axial pressure on the pisiform bone effectively, making the wrist stable and reducing the incidence of carpal bone osteoarthritis. In our preliminary stage of the “Saffar's Procedure,” fusion combination was used infrequently, which may explain the high possibility of osteoarthritis in this study.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of vascularized os pisiform transfer for advanced Kienböck disease after follow-up for at least 15 years

Tan

Xiang²,

Huang³

et al. 2018

Medicine

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No surgical procedure perfectly treats advanced Kienböck disease. Although vascularized os pisiform transferring (VOPT) is one of the main therapeutic approaches, reports on long-term follow-up and case series for this technique are scarce.We collected postoperative results in 11 patients with advanced Kienböck disease who underwent VOPT between 1986 and 2001 in our Hospital. Follow-up durations ranged from 15 to 26 years.At the last follow-up, excellent and good results were found in 81.8% according to the Modified Green and O’Brien score. Postoperative imaging revealed significantly reduced pisiform bone; carpal height ratio and Nattrass index were decreased, while the radioscaphoid angle was increscent, compared with preoperative and mid-term follow-up results.The favorable long-term results demonstrated that VOPT is a dependable and durable procedure for the treatment of advanced Kienböck disease, with pain relief and functional improvement despite some radiographic findings such as wrist osteoarthritis occurrence.

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Section: Discussionmentioning

confidence: 99%

Long-term results of vascularized os pisiform transfer for advanced Kienböck disease after follow-up for at least 15 years

Tan

Xiang²,

Huang³

et al. 2018

Medicine

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“…The vascularized relocation, which is suggested at stage III of conventional classifications, is verified using X-rays and MRI. The method entails employing ligament reconstructions to stabilize the transferred bone and may also include radiation shortening or scaphocapitate-restricted arthrodesis to lessen stress [ 2 ]. The "compromised" wrist's secondary consequences of the falling lunate include the following: at the radiolunate and mid-carpal articulations, the central column is deteriorating; the middle column's collapse; radial column collapse; proximal row instability; and, lastly, radial column degeneration [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation Protocol for Lunate Fracture in a Clinical Case Report

Agrawal,

Deshmukh,

Padmawar

2024

Cureus

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A carpal injury called a lunate fracture can cause severe carpal instability if treatment is not received. After the scaphoid, triquetrum, and trapezium, the lunate is the fourth most frequently fractured carpal bone. Due to lunate fracture, the functional prognosis is uncertain, and conservative treatment frequently results in surgery. Lunate fracture may be caused by anatomical features such as ulnar and radial variation, although necrosis is not commonly one of them. Vascularization in the lunate is unstable and dependent on the capsular arterioles. High shear stresses are frequently applied to the lunate, which rubs against the triangular fibrocartilage complex and the radius. This could lead to a fracture. Intraosseous compartment syndrome is most likely caused by the inflammatory condition Kienböck's disease. In order to protect the lunate against shear and compression loads, surgery entails decompressing the lunate. The consequences of current osteotomy techniques on biomechanics will be discussed. While some osteotomies may lessen the stresses conveyed to the lunate, they may also put too much strain on the ulnar side of the lunate. Techniques for treating wrist degeneration comprise extra-articular methods that keep the mid-carpal joint's architecture and vascularization intact. Bone grafting or repair may be indicated if lunate destruction is extensive. In the last phases, palliative methods are employed. For Kienböck's disease, there are currently no efficient biological therapies. The lunate is prevented from collapsing by decompression osteotomies, giving time for natural healing. The patient came to Acharya Vinoba Bhave Rural Hospital Outpatient Department of Orthopedics with a complaint of pain in her right wrist. At a private hospital in Amravati, the patient had gone through a proximal row carpectomy on the right side. After undergoing post-operative physiotherapy, the patient showed good improvement in her functional activities and quality of life. Physiotherapy helps in gaining back the functional activities for the post-operated lunate fracture patient.

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“…В отношении более поздней стадии (IIIb) единого подхода к хирургическому лечению в настоящее время не существует. Одним из перспективных методов лечения считается транспозиция гороховидной кости в позицию полулунной кости после удаления последней, а также сочетание этой операции с укорачивающей остеотомией лучевой кости [22,23,24]. Именно такой подход в представ-is considered as one of the promising methods of this disease treatment.…”

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Surgical Treatment of Patient with Advanced Kienböck’s Disease: A Case Report

Хоминец

Ткаченко

Иванов

et al. 2020

Traumatology and Orthopedics of Russia

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Relevance. For more than a century, many methods of treating Kienböck’s disease have been developed, although none of them could achieve consistently good results. The transposition of the pisiform into the lunate location after removal of the latter, as well as the combination of this operation with a shortening osteotomy of the radius, is considered as one of the promising methods of this disease treatment. The purpose of this publication was to demonstrate the options of the modern reconstructive surgery for the treatment the stage IIIb Kienböck’s disease. Case presentation. A clinical case of a successful non-free transplant of a blood-supplied pisiform in aseptic necrosis of the lunate is described. A patient was a 21 year old military serviceman with stage IIIb Kienböck’s disease complicated by persistent pain syndrome and severe dysfunction of the left wrist. He underwent removing the fragmented lunate with replacing it with a pisiform on the tendon feeding pedicle and performing simultaneous shortening osteotomy of the radius. The displaced bone was fixed with an anchor to the dorsal surface of the distal radial metaepiphysis. In 12 months after the surgery, an improvement of the wrist function was achieved in the form of an increase in the range of motion compared with the preoperative period and a significant decrease in the level of pain syndrome. The radiological examination at the same time showed the preservation of the shape, size and intraarticular localization of the bone autograft. Conclusion. The use of transposition of the blood-supplied pisiform on a permanent tendon feeding pedicle into the region of the removed lunate demonstrated, in our opinion, the favorable possibilities of successful surgical treatment of the late stages of Kienböck’s disease. A favorable outcome of such treatment is possible only in a specialized hospital, where there are trained specialists in the field of hand surgery, and there are also opportunities for employment a modern rehabilitation complex aimed at restoring movements in the hand joints, taking into account the strength and coordination parameters of its anatomical structures.

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

Cited by 19 publications

References 6 publications

Long-term results of vascularized os pisiform transfer for advanced Kienböck disease after follow-up for at least 15 years

Long-term results of vascularized os pisiform transfer for advanced Kienböck disease after follow-up for at least 15 years

Rehabilitation Protocol for Lunate Fracture in a Clinical Case Report

Surgical Treatment of Patient with Advanced Kienböck’s Disease: A Case Report

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