Abstract
We performed vascularized medial femoral trochlea osteochondral grafting for a 64-year-old female with Bain Grade 2b Kienböck disease. At one year postoperatively, her wrist pain had disappeared, her active wrist range of motion was 90 degrees on flexion and extension, her Mayo wrist score was 80, her knee function at the graft donor site was almost normal, and she was satisfied with the results. The carpal height ratio and the radioscaphoid angle were maintained on X-ray, and fragmentation of the lunate had united on CT. Although there are few reports on vascularized medial femoral trochlea osteochondral grafts for Kienböck disease, it is possible to reconstruct the proximal articular surface of lunate and unite fragmentation of the lunate using this procedure, making it more advantageous than other procedures such as radial osteotomy, partial wrist fusion, and proximal row carpectomy. Therefore, the vascularized medial femoral trochlea osteochondral graft should be indicated for Bain Grade 1 and 2b Kienböck disease.
