2025 Volume 38 Issue 3 Pages 81-87
This report presents the outcomes of treating Kienböck’s disease with vascularized bone graft (VBG) and temporary scaphocapitate fixation at our institution. Seven patients with Lichtman stageⅢa orⅢb were included. Pre- and postoperative assessments included palmar and dorsal flexion, pronation-supination range of motion, grip strength, wrist pain, Japanese Orthopedic Association wrist score, carpal height ratio (CHR) , Stahl’s lunate index (STI) , radioscaphoid angle (RSA) , and radiolunate angle. The surgical technique involved harvesting a VBG from the distal radius using the 4-5 extensor compartmental artery (4-5 ECA) as the pedicle, followed by temporary fixation between the scaphoid and capitate using two 1.5 mm K-wires, which were removed at an average of 16.0 weeks postoperatively. Postoperative improvements in grip strength and wrist function were observed across all stages . However, no significant differences were noted in CHR, STI, or RSA before and after surgery. No progression of lunate bone collapse was observed at the final follow-up visit. Combining VBG with temporary scaphocapitate fixation is a viable option for treating Kienböck’s stagesⅢa andⅢb.
