Osteochondral free flap reconstruction of advanced kienböck’s disease

James Patrick Higgins, Heinz K. Bürger

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The medial femur provides a source of convex osteochondral vascularized bone. The morphology of the medial trochlea has been shown to have similar contour to the proximal lunate. This analogous structure offers the ability to provide reconstruction of the avascular lunate and restoration of carpal height in advanced Kienböck’s disease. This chapter reviews the author’s clinical experience with this technique and the available published data. The indications, surgical technique, postoperative management, and clinical and radiographic results are presented. Future directions of research are discussed, including donor site morbidity and the relevance microvascular perfusion of the transferred osteochondral segment. Early clinical experience with medial femoral trochlea reconstruction of the diseased lunate demonstrates a successful restoration of the carpal height and lunate morphology with excellent viability and union rates, acceptable ROM, and good pain relief. This is a promising tool for reconstruction of advanced Kienböck’s disease in younger patients.

Original languageEnglish (US)
Title of host publicationKienbock's Disease: Advances in Diagnosis and Treatment
PublisherSpringer International Publishing
Pages215-225
Number of pages11
ISBN (Electronic)9783319342269
ISBN (Print)9783319342245
DOIs
StatePublished - Jan 1 2016

Keywords

  • Descending geniculate artery
  • Kienböck’s disease
  • Medial femoral condyle
  • Medial femoral trochlea flap
  • Osteocartilagenous autograft
  • Vascularized bone

ASJC Scopus subject areas

  • Medicine(all)

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    Higgins, J. P., & Bürger, H. K. (2016). Osteochondral free flap reconstruction of advanced kienböck’s disease. In Kienbock's Disease: Advances in Diagnosis and Treatment (pp. 215-225). Springer International Publishing. https://doi.org/10.1007/978-3-319-34226-9_19