Lichtman DM, Alexander AH, Mack GR, Gunther SF. Kienbock’s disease: The role of silicone replacement arthroplasty. J Bone Joint Surg Am ; Antuña Zapico JM. Enfermedad de Kienbock. Rev. t ; 37 IB ( Supl.I): Antuña Zapico JM. Malacia del Semilunar. Tesis Doctoral Kienbock’s disease is a condition characterized by interruption of blood supply to one of the small bones of the hand near the wrist (the lunate). If blood supply to.
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Trumble T, Irving J. Traumat ; 37 IB Supl. Despite this, the patient continues to complain of weakness, stiffness, and pain with exertion of right hand. Scapholunate instability occurs following disruption of the scapholunate ligaments and is accompanied by the proximal capitate migration into the scapholunate interval.
C and D Note the changes on the MRI, including the edema of the volar ligaments at the lunotriquetral articulation white arrow. DOI of the erratum is Arhtritis Rheum ; enfetmedad B Reformatted image of the same lunate, superimposed on a normal lunate. He denies any history of trauma. The venous obstruction produces edema of the fat cells, which potentiates the hypertension.
L8 – 10 years in practice. Avascular necrosis of the lunate leading to abnormal carpal motion Epidemiology incidence most common in males between years old risk factors history of trauma Pathophysiology thought to be caused by multiple factors biomechanical factors ulnar negative variance leads to increased radial-lunate contact enfermesad decreased radial inclination repetitive trauma anatomic factors geometry of lunate vascular supply to lunate patterns of arterial blood supply have differential incidences of Envermedad disruption of kienbkck outflow leading to increased intraosseous pressure Prognosis progressive and potentially debilitating condition if unrecognized and untreated.
Templeman D, Engber W. The small box on the left of image depicts the area demonstrated in the magnified views show in Bwhere the venule within the subarticular plexus seen in profile.
Kienbock’s Disease – Hand – Orthobullets
Once the subchondral bone is breached, the friable medullary trabeculae are exposed and comminution and collapse occur. With repetitive loading, a stress microfracture will occur, and with further loading, the fracture will propagate. Hand Surg ; 24 B, 5: Proximal row instability is due to disruption of the linkage between the three columns. Kenzora J, Glimcher M. The proximal subchondral bone plate is a cantilever, at the site of the thin proximal subchondral bone plate.
REVISTA PATOLOGÍA DEL APARATO LOCOMOTOR
Clinical Orthopaedics The Classic Tech Hand Up Extrem Surg. Bain G I, Begg M. The proximal carpal row is now unstable, and is similar to scapholunate instability, where the capitate migrates between the scaphoid and lunate. Lunate comminution, disruption of the spanning trabeculae or a coronal lunate fracture will result in the collapse of the lunate.
See J Wrist Surg.
The intraosseus arterial pattern of the carpal lunate bone and its relation to avascular necrosis. Fractures kifnbock the lunate subchondral bone plate produce irregularity of the lunate articular surface. Cast immobilization did not lead to any improvement so surgery was performed. Journal List J Wrist Surg v.
Deformity and Collapse of the Central Column The loss of height of the lunate and degeneration of the perilunate articulations produces a loss of height of the central column. Infectious Diseases in Clinical Practice ; The lunate collapses when snfermedad fracture enfrmedad comminuted, or there is disruption of the spanning trabeculae or a coronal fracture. If the fracture remains localized, it can heal or settle into a stable configuration, so that the wrist remains functional.
L6 – years in practice. We believe this is in part related to the venous hypertension.
SPECT, single-photon emission computed tomography. Arthroscopic core decompression of the lunate in early stage Kienbock disease of the lunate. Hand ; 14, The increased osseous compartment pressure further potentiates the venous obstruction, producing avascular necrosis.
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La maladie de Kienbock chez le mineur. The factors that impact on the osseous compartment pressure include the arterial supply, emboli, venous drainage, and the intraosseous marrow.
Deformity and collapse of the central column. This creates a static deformity, which in time becomes a fixed deformity. Hand Surg ; 20 A, 1: Stress Fracture of the Lunate Prior to the stress fracture occurring in the lunate, while the lunate is being abnormally loaded, a physiological response can enfermeddad seen on imaging.
He denies any recent history of trauma to the wrist or hand.
In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. It is generally considered that there is a vascular disturbance which occurs in an at-risk lunate. This article has been cited by other articles in PMC.
The uncovered type I lunate. A negative ulnar variance is important, as the ulnar is then unable to disperse the load from the lunate or triquetrum. Engermedad Viegas type 1 lunate has a single articular facet for the capitate and positions the capitate in a more radial direction. Acta Chirurg Scand ; 1, supl.