Coronal Fracture of the Lunate in Advanced Kienböck Disease: Reestablishing Midcarpal Congruency to Enable Osteochondral Reconstruction: A Case Report

Joshua A. Gillis, James P. Higgins

Research output: Contribution to journalArticle

Abstract

CASE: We describe a patient with Bain grade-2b Kienböck disease with a coronal fracture of the distal lunate articular surface with proximal structure collapse. To reestablish midcarpal congruity, we used a bone-anchored suture to repair the coronal split in the lunate in preparation for lunate preservation with osteochondral medial femoral trochlea (MFT) reconstruction. CONCLUSION: In Bain grade-2b Kienböck disease, lunate reconstruction of both the proximal and distal joint surfaces can be performed. Successful reconstruction of the distal articular surface can be achieved using a bone-anchored FiberWire (Arthrex) suture technique. This can be employed in conjunction with an osteochondral MFT reconstruction of the proximal aspect of the lunate. Patients with this commonly encountered coronal fracture of the distal articular surface may be considered candidates for lunate reconstruction via this technique rather than conventional ablative procedures.

Original languageEnglish (US)
Pages (from-to)e37
JournalJBJS case connector
Volume8
Issue number2
DOIs
StatePublished - Apr 1 2018
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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