Outcomes of advanced Kienbock' s diseases treated by vascularized pedicled distal radius bone graft

Abstract

Objective To investigate the outcomes of advanced Kienbock' s diseases treated by vascularized pedicled distal radius bone flap transfer.Method Two patients with advanced Kienbock's diseases ( type Ⅴ) underwent distal radius bone flap transfer pedicled by dorsal branches of the radial artery.The observations included pain evaluation,radiography,function assessment of the wrist ( range of motion and Krimmer scale),and quality of life ( DASH questionnaire).Results Pain disappeared after surgery in both patients at rest,and reduced in intensity to a mild level during wrist motion.In one patient,X-ray showed the high density image of the lunate had disappered and now bone had formed.In the other patient,there was no aggravation in X-ray or MRI.According to the assessment of hand function,the Krimmer score and DASH score were higher comparing with that assessed before the operation.Conclusion Distal radius bone flap transfer pedicled by dorsal branches of the radial artery is a feasible procedure to treat advanced Kienbock's diseases,with favorable preliminary results. Key words: Kienbock' s disease; Surgical procdures,operative; Bone flaps