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Journal of the Korean Society for Surgery of the Hand 2009;14(1):6-11.
Published online March 1, 2009.
4+5 Extensor Compartmental Vascularized Bone Graft for Stage III Kienbock's Disease : Preliminary Results
Ung Seo Chung, Ki Chun Kim, Kwang Hyun Lee
1Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Korea. leegh@hanyang.ac.kr
2Department of Orthopaedic Surgery, Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
Abstract
Purpose
The aim of this study was to evaluate the preliminary results using the 4+5 extensor compartmental vascularized bone graft for the treatment of stage III Kienbock's disease and to report the usefulness of this procedure.

Methods
A retrospective study was carried out on five patients who had undergone 4+5 extensor compartmental vascularized bone graft for stage III Kienbock's disease between Jan. 2005 and Aug. 2006. All patients were composed of two patients in stage IIIA and three patients in stage IIIB according to Lichtman classification. The radiographic findings were evaluated by carpal height ratio, Stahl's index, ulnar variance and scapholunate angle. The clinical outcome was assessed using the Mayo wrist score.

Results
The mean age of 43.4 years(range, 21-61) and the mean follow up of 23.6 months(range, 14-31) were presented. All patients were satisfied and the mean Mayo wrist score was 78(range, 70-85). Two patients showed further lunate collapse on follow-up radiographs. Four patients had no pain in the activity of daily living, one patient had a mild occasional pain.

Conclusion
The 4+5 extensor compartmental vascularized bone graft for the surgical treatment of stage III Kienbock's disease is the effective treatment showing satisfactory clinical results, but a lunate collapse proceeds. Before this operation, the possibility of lunate collapse should be considered.
 


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