This book covers the pathogenesis, etiology, diagnosis and treatment options for avascular necrosis of the lunate, offering readers a systematic overview of Kienbock’s disease. Each chapter shares scientific findings and abundant illustrations on the latest advances in the diagnosis and treatment of the disease. Although some factors are known to be associated with this condition, there are no conclusively verified causes or standard treatment. This book provides an essential basis for new approaches and further research into this largely unexplained condition. Accordingly, it offers a valuable resource for hand and orthopedic surgeons, clinical residents and medical students seeking a thought-provoking, instructive and informative read.
Author(s): Norimasa Iwasaki
Publisher: Springer
Year: 2023
Language: English
Pages: 117
City: Singapore
Contents
Part I: Introduction
1: Introduction
References
Part II: Pathogenesis and Basic Science
2: Wrist Anatomy and Vascularity
References
3: Wrist Biomechanics of Kienböck’s Disease
3.1 Introduction
3.2 Kinetics and Kinematics of the Normal Lunate
3.2.1 Midcarpal Joint
3.2.2 Radiocarpal Joint
3.3 Morphological Influence on and Kinetics of Kienböck’s Disease
3.3.1 Morphological Influence
3.3.2 Kinetics
3.4 Kinetic Efficacy of Different Types of Surgical Decompression Procedures
3.4.1 Radial Shortening Osteotomy
3.4.2 Radial Wedge Osteotomy
3.4.3 Capitate Shortening Osteotomy
3.4.4 Partial Capitate Shortening
3.4.5 Intercarpal Fusions
References
Part III: Etiology
4: Etiology
4.1 Arterial Injury Theory
4.2 Fracture Theory
4.3 Ulnar Variance Theory
References
Part IV: Diagnosis
5: History and Presentation
References
6: Imaging
6.1 Standard Radiographs
6.1.1 Ulnar Variance
6.1.2 Radial Inclination
6.1.3 Carpal Height Ratio
6.1.4 Radioscaphoid Angle
6.1.5 Size or Shape of the Lunate
6.2 Magnetic Resonance Imaging
6.3 Computed Tomography
6.4 Staging
References
Part V: Treatment and Outcome
7: Treatment Strategy
References
8: Conservative Treatments
8.1 Introduction
8.2 Conservative Treatments for Young Patients
8.3 Conservative Treatments for Elderly Patients
8.4 Conservative Treatments for Adults (Aged 21–70 Years)
References
9: Surgical Treatments: Revascularization
9.1 Introduction
9.2 Harvest from Dorsal Distal Radius
9.3 Harvest from Volar Distal Radius
9.4 Dorsal Metacarpal Artery Pedicled Vascularized Bone Graft
9.5 Vascularized Pisiform Bone Graft
9.6 Free Vascularized Iliac Crest Bone Graft
9.7 Vascularized Pedicle Implantation
9.8 Reconstruction of Lunate Using Free Medial Femoral Trochlea Osteochondral Free Flap
9.9 Partial Reconstruction of Radiolunate Joint Using Vascularized Capitate Transposition Technique
9.10 Combination of VBG with Joint Leveling Procedure
9.11 Comparison of Clinical Outcome Between VBG and Joint Leveling Procedures
9.12 Summary
References
10: Surgical Treatments: Radial Osteotomy
10.1 Introduction
10.2 Surgical Technique
10.3 Clinical Study
10.4 Patients and Methods
10.4.1 Patients
10.4.2 Outcome Measures
10.4.3 Statistical Analysis
10.5 Results
10.5.1 Younger Group (39 Years and Under)
10.5.2 Older Group (40 Years and Over)
10.5.3 Inter-group Comparison
10.6 Discussion
10.7 Conclusion
References
11: Surgical Treatments: Capitate Shortening Osteotomy
References
12: Surgical Treatments: Limited Intercarpal Fusion
References
13: Surgical Treatments: Lunate Excision
13.1 Author’s Preferred Technique [1, 22]
References
14: Surgical Treatments: Salvage Operations
14.1 Author’s Preferred Technique
References
