Lichtman DM, Alexander AH, Mack GR, Gunther SF. Kienbock’s disease: The role of silicone replacement arthroplasty. J Bone Joint Surg Am ; Antuña Zapico JM. Enfermedad de Kienbock. Rev. t ; 37 IB ( Supl.I): Antuña Zapico JM. Malacia del Semilunar. Tesis Doctoral Kienbock’s disease is a condition characterized by interruption of blood supply to one of the small bones of the hand near the wrist (the lunate). If blood supply to.
|Published (Last):||3 June 2006|
|PDF File Size:||6.12 Mb|
|ePub File Size:||20.72 Mb|
|Price:||Free* [*Free Regsitration Required]|
How would you treat this patient’s Kienbocks’s disease? HPI – Patient is a 22 year old healthy LHD male college student with more than 6 months of pain and stiffness in his right wrist. Beitrr z Klin Chir ; It is generally considered that there is a vascular disturbance which occurs in an at-risk lunate. Infectious Diseases in Clinical Practice ; Revascularization may cause collapse. Clin Orthop Relat Res. Increased intraosseous pressure in the lunate is seen in KD, and rises significantly on wrist extension.
Initially, the enfermedadd column deformity is correctable, so lunate and central column reconstructive procedure could be effective. Cast immobilization did not lead to any improvement so surgery was performed.
For which of the depicted conditions is temporary scaphotrapeziotrapezoidal pinning most indicated? Analogy with Scapholunate Instability As noted there are several similarities between KD and scapholunate instability.
Core Kkienbock Community All. Lee and Gelberman have both studied the arterial supply of the lunate, and reported that a single volar artery can exist, and report that this is likely to be a risk factor for KD. Application of magnetic resonance imaging to ischemic necrosis of the lunate.
This article has been cited by other articles in PMC. J Hand Surg Am. Radiographs of the right wrist are shown in Figure A. Open in a separate window.
He denies any history of trauma. Four Corner Koenbock Fusion. If the fracture remains localized, it can heal or settle into a stable configuration, so that the wrist remains functional. Universidad de Valladolid, Servicio de Publicaciones; Please login to add comment.
L7 – years in practice. The scaphoid is kiebock into flexion by the trapezium, however, degeneration of the scaphoid and scaphoid facet only occurs in late disease or following failed surgery.
The proximal carpal row becomes unstable, as unbalanced forces push the scaphoid into flexion and lunate into extension dorsal enferkedad segmental instability [DISI]. However, there is an extensive void, due to resorption of much of the medullary lunate. Once the radioscaphoid articulation is also compromised, the wrist is now unreconstructable failedand a salvage procedure is then required.
The Etiology and Pathogenesis of Kienböck Disease
A and B Global sclerosis of the lunate, with large volar perforations of the lunate and triquetrum. Please vote below and help us build the most advanced adaptive learning platform in medicine. A A composite image of subarticular venous plexus and 3D micro-CT of the subchondral bone plate. We propose that two mechanisms exist which may lead to AVN of the lunate; either as a localized or global lunate phenomenon.
A negative ulnar variance leads to increase the loading of the radiocarpal joint—thereby distributing more stress to the lunate than would otherwise occur in an ulnar-neutral wrist. The uncovered type I lunate is positioned on the radial edge of the lunate, and with power grip in ulnar deviation loads on the radial edge of the radius. The proximal carpal row is now unstable, and is similar to scapholunate instability, where the capitate migrates between the scaphoid and lunate.