Scapho-Capitate一時的固定を併用した有茎血管柄付き骨移植術を施行したKienböck病の術後成績

抄録

　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.