SEMILUNATE REVASCULARISATION AFTER KIENBÖCK NECROSIS USING A VASCULARISED ISLAND BONE GRAFT ON THE ANTERIOR ASPECT OF THE RADIUS: RESULTS AT MINIMUM THREE YEARS FOLLOW-UP

Purpose: We report our experience with vascularised bone grafts harvested from the anterior aspect of the radius for the treatment of Kienbock disease. We reviewed our patients at minimum three years, average 67 months.Material and methods: We treated 22 patients with Kienbock disease, eight women and fourteen men, mean age 31.4 years (18–63). Pain was present in all cases and was disabling in nineteen. After systematic computed tomography and magnetic resonance imagine (MRI), the Buchler classification was stage II=8, stage IIA=10 and stage IIIB=4. The transverse anterior artery of the carpus arises from the radial artery and supplies blood to the medial part of the radial epiphysis. The pediculated bone graft fed by this artery can be harvested via the same anterior approach as used to position it in the semilunate for revascularisation. Radial shortening was performed in all cases. The patients were immobilised until the radius healed.Results: Mean follow-up was 67 months (36–104). Pain resolved comple...