Long-term functional result of vascularized bone graft for kienbock disease: A case report
1 Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
2 Cell and Tissue Bank, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Case Study
World Journal of Advanced Research and Reviews, 2024, 21(01), 2149–2154
Publication history:
Received on 07 December 2023; revised on 15 January 2024; accepted on 18 January 2024
Abstract:
Introduction: Kienbock's disease, or lunatomalacia, was a condition of aseptic osteonecrosis of the os lunatum, which can be progressively developed with a state of lunatum collapse, followed by complete os carpal collapse. This disease has been known for a long time, but until now, the exact cause of this disease could not be explained. .
Case Presentation: We reported a 32-year-old female patient with pain in the right wrist; the pain was felt for five years before the surgery and is getting worse. On physical examination, Phalen's and Reverse Phalen's tests found pain and limited movement in the right wrist area. A collapse of the os lunatum was found after a radiological examination. The evaluation using the DASH score was an improvement in clinical conditions with the absence of pain on the right wrist after surgery using a vascularized bone graft. The clinical evaluation using Phalen's and Reverse Phalen's tests showed normal flexion and wrist extension results with no movement limitation around 0-90° flexion-extension. The wrist pronation and supination also showed normal results with pronation angles around 0-75° and supination angles around 0-85°.
Conclusion: There were clinical, functional, and radiographic improvements in younger female patients with Kienbock's Disease treated with vascularized bone graft surgery six years after surgery.
Keywords:
Neglected; Kienbock disease; Vascularized bone graft; DASH score
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