Lateral closing wedge osteotomy is a treatment for Kienbock’s disease. It is one of the most frequently used treatment options, which has been reported with relatively good long-term results. However, the results abo...Lateral closing wedge osteotomy is a treatment for Kienbock’s disease. It is one of the most frequently used treatment options, which has been reported with relatively good long-term results. However, the results about the treatment are still controversial in some literatures and some key mechanisms are still not clear. The objective of the cur-rent study was to study the biomedical mechanism of the treatment. A finite element model was developed based on the geometry of carpal bones. Various situations in-cluding inclination angle changes by cutting the radial with 0?, 5?, 10? and 15? osteot-omy angles were studied. The effectiveness of the treatment was also studied for the carpal structure with abnormal positions of the lunate bone. The results show that the effectiveness of the stress reduction with the angle depends on many situations such as the initial morphology of the carpal structure.展开更多
Objective To investigate the clinical application of capitate transposition with a pedicle in 30 cases of Kienbock’s disease.Methods The external diameter and curvature of the capitate head and proximal facet of the ...Objective To investigate the clinical application of capitate transposition with a pedicle in 30 cases of Kienbock’s disease.Methods The external diameter and curvature of the capitate head and proximal facet of the lunate were observed and measured in 100 specimens. The vascularity of the capitate was also investigated. Capitate transposition with a vascular pedicle was designed to treat 30 patients with advanced Kienbock’s disease who were followed up for 2 to 16 years and then analyzed according to Evans's scoring system.Results Aseptic necrosis did not occur in the transposed capitate because the pedicle fascia including the dorsal branch of the anterior interosseous artery ensured the vascularity of proximal two thirds of the capitate. The transposed capitate reestablished a relatively pain-free radiocarpal joint. Follow-up results showed that grip strength and motion arc were up to 70% of contralateral side.Conclusions Capitate transposition with a pedicle is a reliable treatment method for advanced Kienbock’s disease,with favorable prognosis for at least five years postoperatively.展开更多
文摘Lateral closing wedge osteotomy is a treatment for Kienbock’s disease. It is one of the most frequently used treatment options, which has been reported with relatively good long-term results. However, the results about the treatment are still controversial in some literatures and some key mechanisms are still not clear. The objective of the cur-rent study was to study the biomedical mechanism of the treatment. A finite element model was developed based on the geometry of carpal bones. Various situations in-cluding inclination angle changes by cutting the radial with 0?, 5?, 10? and 15? osteot-omy angles were studied. The effectiveness of the treatment was also studied for the carpal structure with abnormal positions of the lunate bone. The results show that the effectiveness of the stress reduction with the angle depends on many situations such as the initial morphology of the carpal structure.
文摘Objective To investigate the clinical application of capitate transposition with a pedicle in 30 cases of Kienbock’s disease.Methods The external diameter and curvature of the capitate head and proximal facet of the lunate were observed and measured in 100 specimens. The vascularity of the capitate was also investigated. Capitate transposition with a vascular pedicle was designed to treat 30 patients with advanced Kienbock’s disease who were followed up for 2 to 16 years and then analyzed according to Evans's scoring system.Results Aseptic necrosis did not occur in the transposed capitate because the pedicle fascia including the dorsal branch of the anterior interosseous artery ensured the vascularity of proximal two thirds of the capitate. The transposed capitate reestablished a relatively pain-free radiocarpal joint. Follow-up results showed that grip strength and motion arc were up to 70% of contralateral side.Conclusions Capitate transposition with a pedicle is a reliable treatment method for advanced Kienbock’s disease,with favorable prognosis for at least five years postoperatively.
