Arthroplasty for advanced Kienbock's disease using a radial bone flap with a vascularised wrapping of pronator quadratus

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Gong, H. S.; Chung, M. S.; Lee, Y. H.; Lee, S.; Lee, J. O.; Baek, G. H.
Issue Date
British Editorial Society of Bone and Joint Surgery
J Bone Joint Surg [Br] 2006;88:623-8
Arthroplasty, Replacement/*methodsLunate Bone/surgeryMovement/physiologyOrthopedic Procedures/methodsOsteonecrosis/physiopathology/radiography/*surgeryPain/physiopathologyRadius/*transplantationWrist Joint/physiopathology/radiography/*surgery
We have performed a form of lunate replacement arthroplasty, which included excision of the lunate and insertion of a vascularised radial bone flap wrapped in pronator quadratus, for stage IIIB or stage IV Kienbock's disease, in 41 patients who have been followed up for more than three years. All patients reported an improvement in their symptoms, and 20 of the 41 became free of pain after the operation. Extension and flexion of the wrist were increased by a mean of 9 degrees and 6 degrees , respectively (p < 0.05). The radioscaphoid angle and the carpal height ratio were not significantly changed and only minimal deterioration was observed due to degenerative change. The size, density or location of the inserted bone did not change with time. A vascularised radial bone flap wrapped in pronator quadratus can be a reliable treatment option for advanced Kienbock's disease, when the pedicled bone and muscle envelope acts as a stable spacer for the excised lunate.
0301-620X (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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