Vascularized bone grafting from the dorsal distal radius based on 4th extensor compartment artery for Kienböck’s disease. Current concepts and a new surgical technique
Keywords:
Kienböck’s disease, vascularized bone grafting, 4th extensor compartment artery
Abstract
The optimal treatment option for Kienböck’s disease is determined by the stage of the disease, ulnar variance, status of the lunate cartilage shell and presence of arthritic changes. The vascularized bone grafts are attractive treatment options for stage II and III according to Stahl-Lichtman classification. The purpose of this article is to present an overview for Kienböck’s disease and describe our technique of the 4th extensor compartment artery vascularized bone graft for Kienböck’s disease and its usefulness in the current concepts of treatment for Kienböck’s disease.
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References
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2. Lutsky K, Beredjiklian PK. Kienböck disease. J Hand Surg Am 2012;37(9):1942–1952
3. Schiltenwolf M, Martini AK, Mau HC, Eversheim S, Brocai DR, Jensen CH. Further investigations of the intraosseous pressure characteristics in necrotic lunates (Kienböck’s disease). J Hand Surg 1996;21A:754–758.
4. Goeminne S, Degreef I, De Smet L. Negative ulnar variance has prognostic value in progression of Kienböck’s disease. Acta Orthop Belg 76:38–41
5. Han KJ, Kim JY, Chung NS, Lee HR, Lee YS. Trabecular microstructure of the human lunate in Kienbock’s disease. J Hand Surg 2012;37E:336 –341.
6. Kristensen SS, Thomassen E, Christensen F. Kienböck’s disease—late results by non-surgical treatment. A follow-up study. J Hand Surg 1986;11B:422– 425.
7. Beckenbaugh RD, Shives TC, Dobyns JH, Linscheid RL. Kienbock’s disease: the natural history of Kienbock’s disease and consideration of lunate fractures. Clin Orthop 1980;Jun(149):98 –106
8. Delaere O, Dury M, Molderez A, et al. Conservative versus operative treatment for Kienbock’s disease: a retrospective study. J Hand Surg Br. 1998;23B:33–6
9. Dias J, Lunn P. Ten questions on kienbock’s disease of the lunate. J Hand Surg Eur. 2010;35B:538–43.
10. Lichtman DM, Lesley NE, Simmons SP. The classification and treatment of Kienbock’s disease: the state of the art and a look at the future. J Hand Surg 2010;35E:549 –554.
11. Goldfarb CA, Hsu J, Gelberman RH, Boyer MI. The Lichtman classification for Kienbock’s disease: an assessment of reliability. J Hand Surg 2003;28A:74–80.
12. Saunders B, Lichtman D. A classification-based treatment algorithm for Kienbock’s disease: current and future considerations. Tech Hand Up Extrem Surg. 2011;15:38–40.
13. Bain G, Durrant A. An articular-based approach to Kienbock avascular necrosis of the lunate. Tech Hand Up Extrem Surg. 2011;15(1):41–7.
14. Shin AY, Bishop AT. Vascularized bone grafts for scaphoid nonunions and Kienböck’s disease. Orthop Clin North Am 2001;32:263–277
15. Calfee R, Van Steyn M, Gyuricza C, et al. Joint leveling for advanced Kienbock’s disease. J Hand Surg Am. 2010;35A:1947–54
16. Nakamura R, Nakao E, Nishizuka T, et al. Radial osteotomy for Kienbock’s disease. Tech Hand Up Extrem Surg. 2011;15(1):48–54.
17. Nakamura R, Tsuge S,Watanabe K, et al. Radial wedge osteotomy for Kienbock disease. J Bone Joint Surg Am. 1991;73A(9):1391–6.
18. Salmon J, Stanley J, Trail I. Kienbock’s disease: conservative management versus radial shortening. J Bone Joint Surg Br. 2000;82B:820–3.
19. Weiss A, Weiland A, Moore J, et al. Radial shortening for Kienbock disease. J Bone Joint Surg Am. 1991;73A(3):384–91.
20. Takahara M, Watanabe T, Tsuchida H, Yamahara S, Kikuchi N, Ogino T. Long-term follow-up of radial shortening osteotomy for Kienbock disease. Surgical technique. J Bone Joint Surg Am 2009;91(Suppl 2):184–190
21. Quenzer DE, Dobyns JH, Linscheid RL, Trail IA, Vidal MA. Radial recession osteotomy for Kienböck’s disease. J Hand Surg Am 1997;22(3):386–395
22. Waitayawinyu T, Chin S, Luria S, et al. Capitate shortening osteotomy with vascularized bone grafting for the treatment of Kienbock’s disease in the ulnar positive wrist. J Hand Surg Am. 2008;33A:1267–73.
23. Viola R, Kiser P, Bach A, et al. Biomechanical analysis of capitate shortening with capitate hamate fusion in the treatment of Kienbock’s disease. J Hand Surg Am. 1998;23A:395–401.
24. Almquist E. Capitate shortening in the treatment of Kienbock’s disease. Hand Clin. 1993;9:505–12.
25. Gay A, Parratte S, Glard Y, et al. Isolated capitate shortening osteotomy for the early stage of Kienbock disease with neutral ulnar variance. Plast Reconstr Surg. 2009;124:560–6.
26. Bain G, Smith M, Watts A. Arthoscopic core decompression of the lunate in early stage Kienbock disease of the lunate. Tech Hand Up Extrem Surg. 2011;15(1):66–9.
27. Illarramendi A, De Carli P. Radius decompression for treatment of Kienbock disease. Tech Hand Up Extrem Surg. 2003;7 (3):110–3.
28. Hori Y, Tamai S. Blood vessel transplantation to bone. J Hand Surg Am. 1979;4A:23–33.
29. Simmons S, Tobias B, Lichtman D. Lunate revascularization with artery implantation and bone grafting. J Hand Surg Am. 2009;34A:155–60.
30. Tamai S. Bone revascularization by vessel implantation for the treatment of Kienbock’s disease. Tech Hand Up Extrem Surg. 1999;3(3):154–61
31. Daecke W, Lorenz S, Wieloch P, et al. Vascularized os pisiform for reinforcement of the lunate in Kienböck’s disease: an average of 12 years of follow-up study. J Hand Surg Am. 2005;30A:915–22.
32. Mathoulin C,Wahegaonkar A. Revascularization of the lunate by a volar vascularized bone graft and an osteotomy of the radius in treatment of the Kienbock’s disease. Microsurgery. 2009;29:373–8.
33. Bengoechea-Beeby M, Cepeda-Una J, Avascal-Zuloaga A. Vascularized bone graft from the index metacarpal for Kienbock’s disease: a case report. J Hand Surg Am. 2001;26A:437–43.
34. Moran S, Cooney W, Berger R, et al. The use of the 4+5 extensor compartmental vascularized bone graft for the treatment of Kienböck’s disease. J Hand Surg Am. 2005;30A:50–8.
35. Gabl M, Lutz M, Reinhart C, et al. Stage 3 Kienbock’s: reconstruction of the fractured lunate using a free vascularized iliac bone graft and external fixation. J Hand Surg Br. 2002;27B:369–73.
36. Sakai A, Toba N, Oshige T, et al. Kienböck disease treated by excisional arthroplasty with a palmaris longus tendon ball: a comparative study of cases with or without bone core. Hand Surg. 2004;9(2):145–9.
37. Kawai H, Yamamoto K, Yamamoto T, et al. Excision of the lunate in Kienböck’s disease. Results after long-term follow-up. J Bone Joint Surg Br. 1988;70B(2):287–92.
38. Nakamura R, Horii E, Watanabe K, et al. Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienböck’s disease. J Hand Surg Br. 1998;23B:741–5.
39. Tambe A, Ali F, Trail I, et al. Is radiolunate fusion a viable option in advanced Kienbock disease? Acta Orthop Belg. 2007;73:598–603.
40. Yasuda M, Masada K, Takeuchi E, et al. Scaphotrapeziotrapezoid arthrodesis for the treatment of man stage 3B Kienbock disease. Scand J Plast Reconstr Surg Hand Surg. 2005;39:242–6.
41. Lin H, Stern P. “Salvage” procedures in the treatment of Kienbock’s disease: proximal row carpectomy and total wrist arthrodesis. Hand Clin. 1993;9:521–6.
42. Dell PC, Burchardt H, Glowczewskie Jr FP. A roentgenographic, biomechanical and histological evaluation of vascularized and non-vascularized segmental fibula canine autografts. J Bone Joint Surg Am1985;67(1):105–12.
43. Goldberg VM, Shaffer JW, Field G, et al. Biology of vascularized bone grafts. Orthop Clin North Am 1987;18(2):179–85.
44. Rizzo M, Moran SL. Vascularized bone grafts and their applications in the treatment of carpal pathology. Semin Plast Surg 2008;22(3):213–227
45. Elhassan BT, Shin AY. Vascularized bone grafting for treatment of Kienböck’s disease. J Hand Surg [Am] 2009;34(1):146–54.
46. Cooley BC, Gould JS. The effect of venous flow alterations upon patency of rat femoral vein anastomoses. Microsurgery 1992;13(3):138–42.
47. Chacha PB. Vascularised pedicular bone grafts. Int Orthop 1984;8:117–138
48. Afshar A, Eivaziatashbeik K. Long-term clinical and radiological outcomes of radial shortening osteotomy and vascularized bone graft in Kienböck disease. J Hand Surg Am 2013;38(2):289–296
49. Makino M. Vascularized metacarpal bone graft for scaphoid nonunion and Kienböck’s disease. J Reconstr Microsurg 2000;16(4): 261–266
50. Bermel C, Saalabian AA, Horch RE, et al. Vascularization of the dorsal base of the second metacarpal bone: an anatomical study using C-arm cone beam computed tomography. Plast Reconstr Surg 2014;134(1):72e–80e
51. Saffar P. Replacement of the semilunar bone by the pisiform. Description of a new technique for the treatment of Kienböck’s disease [in French]. Ann Chir Main 1982;1(3):276–279
52. Kuhlmann JN, Mimoun M, Boabighi A, Baux S. Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid. J Hand Surg [Br] 1987;12(2):203–210
53. Sheetz KK, Bishop AT, Berger RA. The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicle bone grafts. J Hand Surg 1995;20A:902–914.
54. Doi K, Oda T, Soo-Heong T, Nanda V. Free vascularized bone graft for nonunion of the scaphoid. J Hand Surg 2000;25A:507–519.
55. Fujiwara H, Oda R, Morisaki S, Ikoma K, Kubo T. Long-term results of vascularized bone graft for stage III Kienböck disease. J Hand Surg Am 2013;38(5):904–908
56. Hermans S, Degreef I, De Smet L. Vascularised bone graft for Kienböck disease: preliminary results. Scand J Plast Reconstr Surg Hand Surg 2007;41(2):77–81
57. Kakar S, Giuffre JL, Shin AY. Revascularization procedures for Kienböck disease. Tech Hand Up Extrem Surg 2011;15(1):55–6
58. Nakagawa M, Omokawa S, Kira T, Kawamura K, Tanaka Y. Vascularized bone grafts from the dorsal wrist for the treatment of Kienböck disease. J Wrist Surg 2016;5(2):98–104
59. Cheon SJ, Lim JM, Kim HT, Suh JT. Treatment of Kienböck’s disease using the 4þ5 extensor compartmental vascularized bone grafting procedure: early experience. J Korean Orthop Assoc 2010;45:256e63
60. Chung US, Kim KC, Lee KH. 4þ5 extensor compartmental vascularized bone graft for stage III Kienböck’s disease: preliminary results. J Korean Soc Surg Hand 2009;14:6e11
61. Park IJ, Kim HM, Lee JY, Roh YT, Kim DY, Jeon NH, Kim YD, Kang SH. Treatment of Kienböck’s Disease Using a Fourth Extensor Compartmental Artery as a Vascularized Pedicle Bone Graft. J Plast Reconstr Aesthet Surg. 2016;69(10):1403-10
2. Lutsky K, Beredjiklian PK. Kienböck disease. J Hand Surg Am 2012;37(9):1942–1952
3. Schiltenwolf M, Martini AK, Mau HC, Eversheim S, Brocai DR, Jensen CH. Further investigations of the intraosseous pressure characteristics in necrotic lunates (Kienböck’s disease). J Hand Surg 1996;21A:754–758.
4. Goeminne S, Degreef I, De Smet L. Negative ulnar variance has prognostic value in progression of Kienböck’s disease. Acta Orthop Belg 76:38–41
5. Han KJ, Kim JY, Chung NS, Lee HR, Lee YS. Trabecular microstructure of the human lunate in Kienbock’s disease. J Hand Surg 2012;37E:336 –341.
6. Kristensen SS, Thomassen E, Christensen F. Kienböck’s disease—late results by non-surgical treatment. A follow-up study. J Hand Surg 1986;11B:422– 425.
7. Beckenbaugh RD, Shives TC, Dobyns JH, Linscheid RL. Kienbock’s disease: the natural history of Kienbock’s disease and consideration of lunate fractures. Clin Orthop 1980;Jun(149):98 –106
8. Delaere O, Dury M, Molderez A, et al. Conservative versus operative treatment for Kienbock’s disease: a retrospective study. J Hand Surg Br. 1998;23B:33–6
9. Dias J, Lunn P. Ten questions on kienbock’s disease of the lunate. J Hand Surg Eur. 2010;35B:538–43.
10. Lichtman DM, Lesley NE, Simmons SP. The classification and treatment of Kienbock’s disease: the state of the art and a look at the future. J Hand Surg 2010;35E:549 –554.
11. Goldfarb CA, Hsu J, Gelberman RH, Boyer MI. The Lichtman classification for Kienbock’s disease: an assessment of reliability. J Hand Surg 2003;28A:74–80.
12. Saunders B, Lichtman D. A classification-based treatment algorithm for Kienbock’s disease: current and future considerations. Tech Hand Up Extrem Surg. 2011;15:38–40.
13. Bain G, Durrant A. An articular-based approach to Kienbock avascular necrosis of the lunate. Tech Hand Up Extrem Surg. 2011;15(1):41–7.
14. Shin AY, Bishop AT. Vascularized bone grafts for scaphoid nonunions and Kienböck’s disease. Orthop Clin North Am 2001;32:263–277
15. Calfee R, Van Steyn M, Gyuricza C, et al. Joint leveling for advanced Kienbock’s disease. J Hand Surg Am. 2010;35A:1947–54
16. Nakamura R, Nakao E, Nishizuka T, et al. Radial osteotomy for Kienbock’s disease. Tech Hand Up Extrem Surg. 2011;15(1):48–54.
17. Nakamura R, Tsuge S,Watanabe K, et al. Radial wedge osteotomy for Kienbock disease. J Bone Joint Surg Am. 1991;73A(9):1391–6.
18. Salmon J, Stanley J, Trail I. Kienbock’s disease: conservative management versus radial shortening. J Bone Joint Surg Br. 2000;82B:820–3.
19. Weiss A, Weiland A, Moore J, et al. Radial shortening for Kienbock disease. J Bone Joint Surg Am. 1991;73A(3):384–91.
20. Takahara M, Watanabe T, Tsuchida H, Yamahara S, Kikuchi N, Ogino T. Long-term follow-up of radial shortening osteotomy for Kienbock disease. Surgical technique. J Bone Joint Surg Am 2009;91(Suppl 2):184–190
21. Quenzer DE, Dobyns JH, Linscheid RL, Trail IA, Vidal MA. Radial recession osteotomy for Kienböck’s disease. J Hand Surg Am 1997;22(3):386–395
22. Waitayawinyu T, Chin S, Luria S, et al. Capitate shortening osteotomy with vascularized bone grafting for the treatment of Kienbock’s disease in the ulnar positive wrist. J Hand Surg Am. 2008;33A:1267–73.
23. Viola R, Kiser P, Bach A, et al. Biomechanical analysis of capitate shortening with capitate hamate fusion in the treatment of Kienbock’s disease. J Hand Surg Am. 1998;23A:395–401.
24. Almquist E. Capitate shortening in the treatment of Kienbock’s disease. Hand Clin. 1993;9:505–12.
25. Gay A, Parratte S, Glard Y, et al. Isolated capitate shortening osteotomy for the early stage of Kienbock disease with neutral ulnar variance. Plast Reconstr Surg. 2009;124:560–6.
26. Bain G, Smith M, Watts A. Arthoscopic core decompression of the lunate in early stage Kienbock disease of the lunate. Tech Hand Up Extrem Surg. 2011;15(1):66–9.
27. Illarramendi A, De Carli P. Radius decompression for treatment of Kienbock disease. Tech Hand Up Extrem Surg. 2003;7 (3):110–3.
28. Hori Y, Tamai S. Blood vessel transplantation to bone. J Hand Surg Am. 1979;4A:23–33.
29. Simmons S, Tobias B, Lichtman D. Lunate revascularization with artery implantation and bone grafting. J Hand Surg Am. 2009;34A:155–60.
30. Tamai S. Bone revascularization by vessel implantation for the treatment of Kienbock’s disease. Tech Hand Up Extrem Surg. 1999;3(3):154–61
31. Daecke W, Lorenz S, Wieloch P, et al. Vascularized os pisiform for reinforcement of the lunate in Kienböck’s disease: an average of 12 years of follow-up study. J Hand Surg Am. 2005;30A:915–22.
32. Mathoulin C,Wahegaonkar A. Revascularization of the lunate by a volar vascularized bone graft and an osteotomy of the radius in treatment of the Kienbock’s disease. Microsurgery. 2009;29:373–8.
33. Bengoechea-Beeby M, Cepeda-Una J, Avascal-Zuloaga A. Vascularized bone graft from the index metacarpal for Kienbock’s disease: a case report. J Hand Surg Am. 2001;26A:437–43.
34. Moran S, Cooney W, Berger R, et al. The use of the 4+5 extensor compartmental vascularized bone graft for the treatment of Kienböck’s disease. J Hand Surg Am. 2005;30A:50–8.
35. Gabl M, Lutz M, Reinhart C, et al. Stage 3 Kienbock’s: reconstruction of the fractured lunate using a free vascularized iliac bone graft and external fixation. J Hand Surg Br. 2002;27B:369–73.
36. Sakai A, Toba N, Oshige T, et al. Kienböck disease treated by excisional arthroplasty with a palmaris longus tendon ball: a comparative study of cases with or without bone core. Hand Surg. 2004;9(2):145–9.
37. Kawai H, Yamamoto K, Yamamoto T, et al. Excision of the lunate in Kienböck’s disease. Results after long-term follow-up. J Bone Joint Surg Br. 1988;70B(2):287–92.
38. Nakamura R, Horii E, Watanabe K, et al. Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienböck’s disease. J Hand Surg Br. 1998;23B:741–5.
39. Tambe A, Ali F, Trail I, et al. Is radiolunate fusion a viable option in advanced Kienbock disease? Acta Orthop Belg. 2007;73:598–603.
40. Yasuda M, Masada K, Takeuchi E, et al. Scaphotrapeziotrapezoid arthrodesis for the treatment of man stage 3B Kienbock disease. Scand J Plast Reconstr Surg Hand Surg. 2005;39:242–6.
41. Lin H, Stern P. “Salvage” procedures in the treatment of Kienbock’s disease: proximal row carpectomy and total wrist arthrodesis. Hand Clin. 1993;9:521–6.
42. Dell PC, Burchardt H, Glowczewskie Jr FP. A roentgenographic, biomechanical and histological evaluation of vascularized and non-vascularized segmental fibula canine autografts. J Bone Joint Surg Am1985;67(1):105–12.
43. Goldberg VM, Shaffer JW, Field G, et al. Biology of vascularized bone grafts. Orthop Clin North Am 1987;18(2):179–85.
44. Rizzo M, Moran SL. Vascularized bone grafts and their applications in the treatment of carpal pathology. Semin Plast Surg 2008;22(3):213–227
45. Elhassan BT, Shin AY. Vascularized bone grafting for treatment of Kienböck’s disease. J Hand Surg [Am] 2009;34(1):146–54.
46. Cooley BC, Gould JS. The effect of venous flow alterations upon patency of rat femoral vein anastomoses. Microsurgery 1992;13(3):138–42.
47. Chacha PB. Vascularised pedicular bone grafts. Int Orthop 1984;8:117–138
48. Afshar A, Eivaziatashbeik K. Long-term clinical and radiological outcomes of radial shortening osteotomy and vascularized bone graft in Kienböck disease. J Hand Surg Am 2013;38(2):289–296
49. Makino M. Vascularized metacarpal bone graft for scaphoid nonunion and Kienböck’s disease. J Reconstr Microsurg 2000;16(4): 261–266
50. Bermel C, Saalabian AA, Horch RE, et al. Vascularization of the dorsal base of the second metacarpal bone: an anatomical study using C-arm cone beam computed tomography. Plast Reconstr Surg 2014;134(1):72e–80e
51. Saffar P. Replacement of the semilunar bone by the pisiform. Description of a new technique for the treatment of Kienböck’s disease [in French]. Ann Chir Main 1982;1(3):276–279
52. Kuhlmann JN, Mimoun M, Boabighi A, Baux S. Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid. J Hand Surg [Br] 1987;12(2):203–210
53. Sheetz KK, Bishop AT, Berger RA. The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicle bone grafts. J Hand Surg 1995;20A:902–914.
54. Doi K, Oda T, Soo-Heong T, Nanda V. Free vascularized bone graft for nonunion of the scaphoid. J Hand Surg 2000;25A:507–519.
55. Fujiwara H, Oda R, Morisaki S, Ikoma K, Kubo T. Long-term results of vascularized bone graft for stage III Kienböck disease. J Hand Surg Am 2013;38(5):904–908
56. Hermans S, Degreef I, De Smet L. Vascularised bone graft for Kienböck disease: preliminary results. Scand J Plast Reconstr Surg Hand Surg 2007;41(2):77–81
57. Kakar S, Giuffre JL, Shin AY. Revascularization procedures for Kienböck disease. Tech Hand Up Extrem Surg 2011;15(1):55–6
58. Nakagawa M, Omokawa S, Kira T, Kawamura K, Tanaka Y. Vascularized bone grafts from the dorsal wrist for the treatment of Kienböck disease. J Wrist Surg 2016;5(2):98–104
59. Cheon SJ, Lim JM, Kim HT, Suh JT. Treatment of Kienböck’s disease using the 4þ5 extensor compartmental vascularized bone grafting procedure: early experience. J Korean Orthop Assoc 2010;45:256e63
60. Chung US, Kim KC, Lee KH. 4þ5 extensor compartmental vascularized bone graft for stage III Kienböck’s disease: preliminary results. J Korean Soc Surg Hand 2009;14:6e11
61. Park IJ, Kim HM, Lee JY, Roh YT, Kim DY, Jeon NH, Kim YD, Kang SH. Treatment of Kienböck’s Disease Using a Fourth Extensor Compartmental Artery as a Vascularized Pedicle Bone Graft. J Plast Reconstr Aesthet Surg. 2016;69(10):1403-10
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2020-07-27
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