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Arthroscopic Reconstructive Procedures for Kienböck’s Disease

  • Wing-lim TseEmail author
  • Xiaofeng Teng
  • Bo Liu
  • Clara Wong Wing-yee
  • Pak-cheong Ho
  • Gregory Ian Bain
Chapter

Abstract

Advances in arthroscopic technique have allowed a more accurate assessment and classification of the pathological changes in Kienböck’s disease. This assists in decision making and customizing treatment for the individual patient and their wrist disorder. In our practice arthroscopic reconstructive procedures for Kienböck’s disease include lunate excision, proximal row carpectomy and partial wrist fusions. In advanced Kienböck’s disease where the radioscaphoid articulation is still preserved, we utilize scaphocapitate fusion, which bypasses the load to the radioscaphoid articulation, and therefore unloads the lunate. In this article the specific indications and techniques of arthroscopic scaphocapitate fusion, radioscapholunate fusion and proximal row carpectomy are described.

Keywords

Wrist Kienböck Lunate Arthrodesis Fusion Arthroscopy Radiocapitate Radioscapholunate Scaphotrapeziotrapezoid Carpectomy Scaphoid Capitate 

Supplementary material

Video 25.1

Examination of soft and fragmented distal lunate cartilage in the mid-carpal joint (MP4 7124 kb)

Video 25.2

Lunate excision is performed with an arthroscopic burr within the central of lunate. It is directed radially and then in all directions (MP4 2298 kb)

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Wing-lim Tse
    • 1
    Email author
  • Xiaofeng Teng
    • 2
  • Bo Liu
    • 3
  • Clara Wong Wing-yee
    • 4
    • 5
  • Pak-cheong Ho
    • 6
  • Gregory Ian Bain
    • 7
  1. 1.General Office, Department of Orthopedics and TraumatologyPrince of Wales HospitalHong KongChina
  2. 2.Department of Hand SurgeryNingBo Sixth Hospital of ZhejiangNingboChina
  3. 3.Department of Hand SurgeryBeijing Ji Shui Tan HospitalBeijingChina
  4. 4.Department of Orthopedics and TraumatologyPrince of Wales HospitalHong KongChina
  5. 5.Hong KongChina
  6. 6.Department of Orthopedics and Traumatology, Prince of Wales HospitalChinese University of Hong KongHong KongChina
  7. 7.Upper Limb and Research, Department of Orthopedic SurgeryFlinders University and Flinders Medical CentrerAdelaideAustralia

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