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.
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There are spanning trabeculae principally on the radial aspect. KD is due to structural compromise and the collapse of the lunate.
REVISTA PATOLOGÍA DEL APARATO LOCOMOTOR
National Center for Biotechnology InformationU. Association between lunate morphology and carpal collapse in cases of iienbock dissociation. Degeneration of the Central Column Perilunate Articulations Fractures of the lunate subchondral bone plate produce irregularity of the lunate articular surface.
Avascular necrosis of the lunate and sickle cell anaemia.
Journal List J Wrist Surg v. HPI – Condition started 6 months ago with minor trauma to right hand after falling. SPECT, single-photon emission computed tomography. B Reformatted image of the same lunate, superimposed on a normal lunate. The scaphocapitate fusion is a good surgical option for late Enfermeadd, as it bypasses the diseased central column and mobilizes the wrist through the stabilized radial column.
Hand Surg ; 7: Medial hamate facet of the lunate. Author information Article notes Copyright and Ejfermedad information Disclaimer.
Uber anatomische variationen der Handgelenknochen. Several morphological factors are associated with the condition; all of which increase loading on the radial aspect of the lunate Fig. Lunate collapse, fixed scaphoid rotation. Beitrr z Klin Chir ; We believe this kuenbock in part related to the venous hypertension. The uncovered type I lunate is kjenbock on the radial edge of the lunate, and with power grip in ulnar deviation loads on the radial edge of the radius. The fracture, typically involves the radial half of the lunate and only in the most extensive cases does it involve the ulnar side Fig.
Application of magnetic resonance imaging to ischemic necrosis of the lunate. How would you treat this patient’s Kienbocks’s disease?
LichtmanMD 4, 5. If the fracture kienbpck and heals in a stable configuration, then the articulation will remain functional. The stress fracture occurs, at the point where the fulcrum loads the cantilever.
He also described the subarticular venous plexus, which are parallel veins positioned just below the subchondral bone plate Fig.
Deformity and Collapse of the Central Column The loss of height of the lunate and degeneration of the perilunate articulations produces a loss of height of the central column. Uber anatomische variationen der handgelenkknochen.
Please vote below and help us build the most advanced adaptive learning platform in medicine The complexity of this topic is appropriate for? Received Dde 23; Accepted Apr 6. On physical exam he has tenderness over the dorsal radiocarpal joint. The SPECT scan demonstrates increased uptake within the lunate due to new bone formation and remodeling enfermedxd the lunate. Hand Surg ; 14A: Image courtesy of Dr. Watson HK, Weinzweig J. However, there is an extensive void, due to resorption of much of the medullary lunate.
Kienbock’s Disease
The lunate fracture commences at the point the lunate cantilevers over the edge of the distal radius, and then takes on the shape of the radius. C and D Note the changes on the MRI, including the edema of the volar ligaments at the lunotriquetral articulation white arrow. The secondary effect of the lunate collapse is proximal migration of the capitate between the volar and dorsal fragments, producing collapse of the entire central column.
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.
There is a progression from dynamic, to static, and then becoming a fixed deformity, especially once articular degeneration occurs.
Proximal Row Instability Proximal row instability is due to disruption of the linkage between the three columns. B A coronal fracture propagates across the lunate.
With loss of height of the enfwrmedad column, the trapezium forces the scaphoid into flexion, thereby compromising the radial column.
Arthroscopic enfermedd and classification of Kienbock’s disease. Pathogenesis of idiopathic osteonechrosis: With ulnar deviation the capitate loads principally onto the lunate, which is then distributed to the proximal lunate, at the point where it articulates with the ulnar lip of the radius.