The use of fourth extensor compartment artery bone flap in Kienböck’s disease
Ahmet Nadir Aydemir1, Metin Gönen2, Ali Çağdaş Yorukoğlu1, Mehmet Yücens1, Ahmet Fahir Demirkan1
1Department of Orthopedics and Traumatology, Pamukkale University, Faculty of Medicine, Denizli, Turkey
2Department of Orthopedics and Traumatology, Develi Hatice Muammer Kocatürk State Hospital, Kayseri, Turkey
Keywords: Kienböck, osteonecrosis, pedicle bone flap.
Objectives: This study aims to clinically evaluate the efficacy of pedicle bone flap treatment in stage II Kienböck's disease.
Patients and methods: This retrospective study included 10 patients (8 males, 2 females; mean age 33.3 years; range, 23 to 46 years) treated with pedicle bone flap between January 2012 and June 2016. In all patients, a fourth extensor compartment artery (ECA) pedicle bone flap from the dorsal surface of the radius was prepared and placed through a window opened on the lunate bone. Clinical results of the patients were evaluated according to the Mayo wrist score.
Results: All patients could return to their daily activities after surgery. No superficial or deep infection developed requiring debridement or antibiotic use other than prophylaxis. None of the patients required reoperation due to complications or the progression of the disease. The mean Mayo wrist score was measured as 81 (good).
Conclusion: In this study, results of the fourth ECA pedicle bone flap application were found to be effective in the treatment of avascular necrosis of the lunate bone. Further comparative and long-term follow-up studies are required including large and homogeneous patient groups.