The treatment of Kienböck disease with vascularized bone graft from dorsal radius.

INTRODUCTION: Numerous surgical treatment options are proposed for the Kienböck disease but there has not been a consensus on the most appropriate method yet. The aim of this study is to present our experience and preliminary results of the use of vascularized bone graft from dorsal radius.

MATERIALS AND METHODS: Second and third intercompartmental supraretinacular artery pedicled bone graft has been used to treat 11 patients with Kienböck disease between 2001 and 2006. The average follow-up period was 37 months (range 19-77 months). Pre- and post-operative range of motion, pain and grip strength, radiologic parameters such as carpal height ratio, Stahl index and scapholunate angle were evaluated.

RESULTS: Eleven patients were composed of two stage II, one stage IIIA and eight stage IIIB patients according to Lichtmann classification. At the end of the observation period, five excellent, four good, one fair and one poor results were observed. There were no or little changes in carpal height ratio and Stahl index. Pain has diminished considerably.

DISCUSSION: We believe that the treatment of Kienböck disease with vascularized bone graft from the dorsum of the radius has encouraging results and need no other additional procedures.