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Results for “Lunate Bone”

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At least 19 recordsLinked to original sources
PubMed1996

[Transplantation of pedicled pisiform bone to replace lunate bone with aseptic necrosis].

OBJECTIVE: To find out a new and effective method for the treatment of aseptic necrosis of lunate bone. METHODS: Blood supply and morphology of pisiform bone were investigated in 25 upper limbs and 57 sets of carpal bone from adult cadavers on the basis of anatomical study. The lunate bone was replaced with pisiform bone of pedicled blood vessel and tendon of musculus flexor earpiulnaris in 17 patients with aseptic necrosis of lunate bone (stage III). RESULTS: The patients were followed up for 18-46 months (average of 28 months). Complete relief of pain was obtained in all of the patients, and the range of motion of their wrists was improved. Grip strength was increased by 48.2%. Radiograph showed normal location of transferred pisiform bone without osteosclerosis and atrophy in 16 patients. Atrophy of pisiform bone was found 2 years after operation in one patient. In the 17 patients, 15 resumed their original jobs and 2 changed their jobs for other reasons. CONCLUSION: We consider that the carpal bone chain can be completely preserved by transplantation of pedicled pisiform bone, which it is an effective method to treat aseptic necrosis stage III of lunate bone.

Adult↗
PubMed1982

[Results of modified capitate bone dislocation in lunate bone malacia].

Long-term follow-up after simple "elongating osteotomy" of the capitate in aseptic necrosis of the lunate has failed to produce the good results which would clearly make this procedure the treatment of choice. The surprisingly high subjective evaluation does not correlate well with the prognostically poor X-ray appearances.

Carpal Bones↗
PubMed1987

[Results of vascular pedicled bone transposition in advanced necrosis of the lunate bone].

Beck (1971) recommended transposition of the pisiform bone into the lunate bone for treatment of lunatomalacia in stage I. In the period from 1979 to 1983, this operation was carried out in 12 patients with lunatomalacia in the Orthopaedic Division, University of Heidelberg-Schlierbach. The operation was carried out in five patients with stage II, six patients with stage III and in one patient with stage IV. In five patients, the operation was carried out in combination with shortening of the radius and in one patient in combination with wrist denervation. The transponants healed in all patients. However, restoration of the bone structure and the form of the lunate bone could only be attained after radius shortening. Special attention must be paid to the variance of the forearm bones in selecting the correct procedure in lunatomalacia.

Adolescent↗
PubMed1997

[Callus distraction for progressive lengthening of the capitate bone after resection of the lunate bone in stage III lunate malacia. Surgical technique and 1 year results].

Inspite of the excellent subjective judgement and functional results of Graner's operation in case of Kienbock's disease stage III, this technique is rarely used nowadays because of its high rate (20 to 30%) of disturbed fracture healing due to impaired blood supply. To avoid the risk of complete devascularization in the capitate region, we are using the callotaxis lengthening technique of Ilizaron, carrying out a segmental shifting. After percutaneous temporary SC- or STT-arthrodesis with the scaphoid in the horizontal or high position, the lunate is completely resected using a dorsal approach. Osteotomy of the capitate is carried out at the corpus-collum interval in order to disturb a minimum of the vascular supply to the bone. Seven to ten days postoperatively, distraction is started with a rate of 1 min/day. The desired distraction length is accomplished, when the capitate articular surface fits perfectly into the curvature of the proximal row articular surface. In order to reduce or prevent soft tissue related complications during the consolidation period, the external distractor is replaced by two percutaneous Kirschner-wires. The consolidation period takes twice as long as the distraction period. Since November 1993, fourteen patients presenting a stage III Kienböck's disease have been treated by this new technique. The operative technique, postoperative care, as well as the potential and real complications are described and illustrated by one clinical case.

Adult↗
PubMed1975

[Anatomical investigation of the blood-supply of the lunate bone (author's transl)].

The lunate bone receives its blood-supply via a palmar and a dorsal vascular and fibrous strand. When the wrist is extended the dorsal vessels are caught in a kind of vice formed by the radius and the capitate bone and compressed up to complete occlusion. This mechanism, important for the pathogenesis of Kienböck's disease, is demonstrated on anatomical specimens.

Carpal Bones↗
PubMed1990

[Aseptic necrosis of the lunate bone. Etiology, clinical aspects, stage-adjusted therapy].

The development of the aseptic necrosis of the lunate bone is so far not fully understood. Therapeutical problems result from the very late discovery of the disease and from the central position in the carpal bone system. Bad long-term-results come out of therapies not able to revitalize the lunate bone. Therefore the therapeutical goal attempted must be to keep the structures of the bone alive and to avoid major pathological changes of the whole carpal bone system. More or less good results could be shown for these patients with a total break-down of the lunate bone treated with the intercarpal-arthrodesis described by Graner.

Female↗
PubMed1982

[Dorsal scapho-lunate bone dislocation].

A dorsal scapho-lunate dislocation resulted from a forced hyperflexion of the right wrist. X-rays demonstrated a dorsally displaced lunate bone and a palmar displacement of the distal carpus with respect to the radius. The dorsal dislocation of the lunate and the palmar perilunate dislocation were combined. Treatment consisted of closed reduction, a gauntlet cast and physical therapy. A follow-up radiological examination six years later revealed a palmar form of carpal instability. No subjective complaints were made on the part of the patient.

Adult↗
PubMed1997

Long-term review of fascial replacement after excision of the carpal lunate bone.

Excision of the carpal lunate bone in Kienbock's avascular necrosis gives relief of pain. To maintain grip strength, increase range of motion, and prevent carpal collapse or shifting, this space has been filled with various materials. Forty-three patients received fascial interposition replacement, and the experience and results of 10 patients observed for 10 years or more (range, 10-34) are presented. Pain was relieved. Range of motion was increased. Carpal collapse did not occur. All patients use their hand in an unrestricted, stressful activity. The result of an operation during an extended period is documented.

Adult↗
PubMedDate not supplied

[Bilateral palmar instability with dislocation between the capitate and lunate bones].

Bilateral palmar instability of the wrist with subluxation between capitate and lunate bone. A stable wrist requires intact ligaments as well as a normal shape and size of carpal bones. While the reasons for bony changes are mainly posttraumatic, degenerative diseases and congenital laxity of ligaments as well as traumatic ruptures may cause an insufficiency of the ligaments. The following article deals with a theoretical discussion of carpal instability considering diagnosis, progress, development, and treatment of congenital bilateral palmar carpal instability which caused painful subluxation between the capitate and lunate bone.

Adult↗
PubMed2001

Ulnar variance and the shape of the lunate bone. A radiological investigation.

The authors designed a study to test the hypothesis that the length of the ulna might affect the shape of the lunate bone because of long-term molding during life. This might then be useful to predict the presence or absence of a dynamic or static ulna plus by the shape of the lunate bone. In a prospective study, posterior-anterior wrist x-rays were taken in a standard fashion in 68 patients with a mean age of 34.5 years. Dominance, grip strength, ulnar variance and the shape of the lunate were recorded. Lunate shape, type 1, which is the least molded, was seen most frequently on both the left and right side and did not correlate with the dominant side. The most molded, type 3, was seen less frequently and almost exclusively on the nondominant side. No correlation was found between dynamic ulna plus and the type 3 lunate. Following statistical analysis, no correlation between ulnar variance and lunate shape was found, indicating that the shape of the lunate bone had no predictive value for predicting the presence or absence of a dynamic ulna plus variance. The hypothesis that the length of the ulna might influence the ultimate shape of the lunate could not be demonstrated.

Adolescent↗
PubMed1997

Sheet plastination of the vascularity of the lunate bone--a morphological study.

Using the method of sheet plastination, the vascularity of the lunate bone can be investigated and analyzed. By intraosseous injection, the deep and superficial venous systems are visualized. Transparent sheets with slices of embedded specimens show a three-dimensional presentation of the vascularity of the human carpus different in functional aspects. Comparing hands with a normal and extended wrist position, three mechanisms of impairment of the venous drainage are observed. The anatomical results of this investigation support the hypothesis that venous congestion, resulting from intraosseous hypertension, plays a role in the development of the necrosis of the lunate bone.

Drainage↗
PubMed1999

MR imaging of the type II lunate bone: frequency, extent, and associated findings.

OBJECTIVE: Type II lunate bones have an "extra" facet that articulates with the hamate bone, which frequently leads to arthritis. Because the only prior studies, to our knowledge, on this common and clinically significant variant involved dissection of cadavers, we performed an MR imaging study of the type II lunate. MATERIALS AND METHODS: We retrospectively reviewed MR images obtained at 1.5 T of 186 wrists for frequency of type II lunates, size of the extra facet, amount of hamatolunate apposition, and presence of hamate subchondral edema. Of the 186 wrists, 28 also had correlation with findings on wrist arthroscopy. RESULTS: One hundred seven wrists (57.5%) had type II lunates with an average extra facet size of 4.6 mm (range, 1.2-12.0 mm). Apposition (articulation) of the extra lunate facet with the hamate averaged 77.4% (range, 0-100%). Hamate edema was seen in only nine wrists (4.8%), all of which had type II lunates. Arthroscopic evidence of focal hamate chondromalacia and MR imaging evidence of marrow edema were seen in six of these nine wrists; marrow edema was seen only in wrists with frank cartilage changes on arthroscopy. CONCLUSION: An extra facet (type II lunate) was seen in approximately half of 186 wrists. On MR imaging, type II lunates usually have an innocuous appearance. A large percentage of patients with type II lunates also have chondromalacia, which often is occult on MR imaging. When visible, such chondromalacia is the cause of marrow edema similar to that seen in patients with carpal fractures.

Adult↗
PubMed2006

Population variation in the incidence of the medial (hamate) facet of the carpal bone lunate.

Studies on the wrist joint have shown two types of the carpal bone lunate. In type II lunate there is a facet on the medial side of the lunate for articulation with the proximal pole of the hamate; such a facet is absent in type I lunate. Type II lunates have different kinematics, are more prone to clinically relevant degenerative changes in the hamato-lunate joint and are an uncommon cause of ulnar-sided wrist pain. Ninety plain radiographs showing postero-anterior views of the wrist (52 right and 38 left wrists) were studied in a population of Malays from Malaysia (mean age 48 years; age range 23 to 67 years) to determine the incidence of type I and type II lunates. Our findings were compared with those in other reports in the literature. In Malays, only 24 wrists (26.7%) showed a type II lunate compared to a reported incidence of 50% or more in populations from the Western world. Such a low incidence of type II lunate has not been reported before and may represent a genetic variation in Malays. Consequently, osteoarthritis of the hamate or lunate may play a less significant role in causing ulnar-sided wrist pain in Malays. In conclusion, the prevalence of type II lunate might vary in different population groups and further studies could be necessary to confirm this observation.

Adult↗
PubMed2003

The venous drainage of the lunate bone.

One of the theories as to the etiology and pathogenesis of lunatomalacia (Kienböck's disease) is based on the presentation of an osseous compartment syndrome caused by a venous block in the pedicle. This gave us cause to examine the lunate bone more closely and to investigate possible anatomical causes for the disruption. For this purpose, ten hands were removed from cadavers proximal to the radiocarpal articular space. Through an artificial intraosseous canal, which did not touch the vascular structures of the lunate bone, epoxy could be injected under controlled conditions. The venous drainage, from the exit out of the bones up to the entrance into the comitant veins of the distal forearm, was exposed as a preparation under the microscope. In all preparations a dense plexus of small venous vessels was found at the palmar and dorsal periosteal face which has not previously been described in literature. As this wide plexus is woven into the solid palmar as well as into the dorsal connective tissue, it could be, as we suppose, the weak point of the venous drainage we have been looking for. It is easy to imagine that the rheological situation in this venous segment is impaired and an osseous compartment syndrome is induced by systemic factors as well as by local compression.

Aged↗
PubMed1987

[Long-term results of conservatively operated necroses of the lunate bone].

The authors present a follow-up of 21 patients treated surgically for lunate bone necrosis on average 19.1 years prior to evaluation. A procedure is called conservative when the shape of the lunate is not destroyed by the operation and the mechanism of the wrist is preserved. This paper shows that these methods are indicated in early stages of Kienböck's disease, but despite some satisfied patients they show generally poor results when used for the late stages with fractured lunate and degenerative signs of the entire carpus. Emphasis should be put on the need for early diagnosis of obscure wrist pain to make early treatment possible, in order to avoid later limitation in the range of motion of the carpus. The authors also report their application to the lunate and its problems of Ficat's measurement of bone marrow pressure in necrosis of the femoral head.

Adult↗
PubMed1998

[Intra-osseous ganglion of scaphoid and lunate bones].

We present a patient with intra-osseous ganglion of the left scaphoid and lunate bones. These were excised and a bone graft inserted. 1 year after operation the patient was free of pain, without limitation of wrist motion. Intra-osseous ganglion of the carpal bone is not common and lunate and scaphoid intra-osseous ganglion has rarely been reported. Awareness of this condition may lead to earlier diagnosis and treatment, with satisfactory outcome.

Adult↗