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Stougie SD, Hoogvliet P, Plugge L, Coert JH. Clinical Results of Nonvascularized Metatarsal Articular Bone Grafting for Osteochondral Defects of the Radiocarpal and Distal Radioulnar Joint. J Wrist Surg 2024; 13:127-136. [PMID: 38505203 PMCID: PMC10948242 DOI: 10.1055/s-0043-1768923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/03/2023] [Indexed: 03/21/2024]
Abstract
Background Treatment of post-traumatic osteochondral defects in the radiocarpal and distal radioulnar joint with nonvascularized metatarsal articular bone grafting is an option to restore the joint (cartilage) surface and wrist function. Purpose To evaluate the clinical midterm results of 10 consecutive patients who were treated with a nonvascularized metatarsal bone graft for cartilage bone defects of the lunate facet, scaphoid facet, sigmoid notch, or the radial part of the ulnar head. Patients and Methods Patients with isolated osteochondral defects of the lunate facet, scaphoid facet, sigmoid notch, or radial part of the ulnar head, respectively, as a result of wrist trauma were retrospectively identified in a prospectively collected database. The patients symptoms were limited wrist motion and/or pain. Clinical results and complications were extracted from patient's medical files and two questionnaires consisting of the Patient-Rated Wrist Evaluation and additional questions regarding patient satisfaction and return to work and/or hobby. Results Minor complications occurred in three cases and required surgery. In five cases an acceptable donor site foot morbidity was seen at 1 year. One patient was not satisfied due to persistent wrist pain despite adequate range of motion. One patient could not return to its prior work. Another patient could not resume its hobby. Conclusion Retrospective evaluation of 10 cases with resurfacing of the scaphoid facet, sigmoid notch, and/or lunate facet, or radial part of the ulnar head has shown that osseointegration was possible without a vascular pedicle to the graft in all cases with a (mean) follow-up of 5 years. This technique may become an alternative treatment when implants become less available. Level of Evidence Level III.
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Affiliation(s)
- Shirley D. Stougie
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Peter Hoogvliet
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Lara Plugge
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - J. Henk Coert
- Department of Plastic, Reconstructive and Hand Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
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Autologous replacement of the head of the radius-proximal fibula versus second metatarsal base: an anatomic feasibility study. Arch Orthop Trauma Surg 2022; 143:2437-2446. [PMID: 35532813 PMCID: PMC10110721 DOI: 10.1007/s00402-022-04460-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/18/2022] [Indexed: 11/02/2022]
Abstract
INTRODUCTION This study investigated the anatomic feasibility of a new surgical therapy option for radial head arthrosis using an autologous vascularized bone graft of the second metatarsal and proximal fibula to recreate the proximal radiohumeral joint. MATERIALS AND METHODS Upper and lower extremities of eleven body donors were evaluated using CT prior to anatomic dissection. Several distinct anatomic parameters were measured on the ipsi- and contralateral radial and fibular head and the second metatarsal base: bone diameter, articular surface diameter, head height, metaphyseal (neck) diameter, articular surface radius, total articular surface area, and angulation of the articular surfaces (facet). Each dissection phase was photographed in a standardized fashion and all measurements were repeated by direct caliper-measurements. RESULTS When comparing the proximal radius and fibula to search for anatomic similarities, similar values were found in the maximum articular surface diameter and minimum and maximum measures of the neck diameter. Comparing the proximal radius and the second metatarsal, statistically similar values were found in the maximum neck diameter performing direct measurements and CT evaluation, the maximum head diameter in CT evaluation and the articular facet angulation. CONCLUSIONS Neither the proximal fibula nor the base of the second metatarsal are ideal bone grafts for replacement of the head of the radius. The base of the second metatarsal might be a bit more suitable as a potential donor since the angulation of the proximal articular facet is similar to that of the radius. LEVEL OF EVIDENCE Level IV, anatomic study.
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Oliveira RKD, Ribak S, Brunelli JPF, Aita M, Delgado PJ. Madelung Deformity: Diagnosis and Treatment Options. REVISTA IBEROAMERICANA DE CIRUGÍA DE LA MANO 2021. [DOI: 10.1055/s-0041-1739452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractMadelung deformity (MD) comprises an increased volar and ulnar tilt of the joint facet of the distal radius, secondary to an idiopathic physeal dysplasia. Such change causes radial shortening and consequent distal ulnar prominence, along with wrist pain and loss of motion. Surgery becomes an option in patients with severe deformity that do not respond to conservative treatment.The classic surgical techniques are problematic for adults, as they are specific for children and adolescents, whose radial physis is still open. Very few papers discuss the treatment of adult patients; furthermore, most are focused on the distal radioulnar joint, and thus do not approach the origin of the pathology.When analyzing computed tomography scans with tridimensional reconstruction, a feature of MD, growth arrest of the volar and ulnar portions of the distal radius, is noted, causing the typical distal radius deformity that leads to lack of coverage of the lunate bone. That leads to palmar subluxation of the lunate bone and consequent radiocarpal instability.We herein describe the possibilities of treatment in different stages of evolution, summarizing the authors' view on MD.
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Affiliation(s)
| | - Samuel Ribak
- Department of Hand Surgery, Pontifícia Universidade Católica de Campinas, Campinas, Brazil
| | | | - Márcio Aita
- Department of Hand Surgery, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Pedro J. Delgado
- Department of Hand and Upper Limb Surgery, Hospital Universitário HM Montepríncipe, Universidad CEU San Pablo, Boadilla del Monte, Madrid, Spain
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Del Piñal F, Cromheecke M, Chaves C. Free vascularized second metatarsophalangeal joint transfer for scaphotrapezial joint reconstruction after distal scaphoid excision and carpal collapse: A case report. Microsurgery 2021; 42:282-286. [PMID: 34761831 DOI: 10.1002/micr.30835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/15/2021] [Accepted: 10/22/2021] [Indexed: 11/05/2022]
Abstract
Treatment of the destroyed scaphotrapezial (ST) joint in young patients is challenging due to the limited available options as they might not tolerate the stiffness, loss of grip strength and long-term complications of partial fusions, bone resections, and interposition implants or arthroplasties. This report presents the results of a free osteocutaneous joint transfer used to reconstruct the ST joint in a young patient suffering from ST destruction and carpal collapse. This 34-year-old patient was previously treated for a right scaphoid nonunion with distal scaphoid excision and interposition implant that evolved to destruction of the ST space, symptomatic carpal collapse associated and a ST height loss of 7 mm. The DASH score was 34 and the grip strength of 32 kg. The patient was treated with an osteocutaneous vascularized free transfer from the second metatarsophalangeal joint vascularized by the first dorsal metatarsal artery and anastomosed to the palmar carpal branch of the radial artery and a palmar superficial vein. After 3.5 months, the patient returned to full duty work as a mechanic. At the last follow-up, 3 years after the surgery, the patients had complete range of motion without clinical nor radiological degenerative changes. There were no postoperative complications. The DASH score was 3 and the grip strength was 53 kg. This reconstructive procedure allows to recreate a functional ST joint and to correct a carpal collapse avoiding degenerative wrist changes. It may be proposed to young patients who aim to recover a near normal function of their wrist.
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Pederson WC, Killion E, White L. Reconstruction of a Portion of the Articular Surface of the Distal Radius With a Vascularized Osteochondral Graft From the Proximal Phalanx of the Great Toe. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2021; 3:218-223. [PMID: 35415553 PMCID: PMC8991544 DOI: 10.1016/j.jhsg.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/01/2021] [Indexed: 11/08/2022] Open
Abstract
Distal radius fractures are among the most common injuries to the upper extremity and have a bimodal distribution in younger male patients and older women. Young men suffer from high-energy injuries and older women from fragility fractures. Approximately 50% of these are intra-articular. Timely and appropriate treatment usually will lead to an acceptable outcome, but loss of congruity of the articular surface remains a difficult problem to manage. We report here on the case of a 16-year-old boy with malunion of the radial articular surface with lack of motion and pain. He was managed by replacing the displaced and damaged segment of the radial articular surface with a vascularized osteochondral graft from the proximal phalanx of the great toe. This matched the shape of this portion of the radius quite well, and he has had improvements in motion and pain in the 10 months since that time. The donor site has not caused him any difficulty to date.
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The Use of the Proximal Hamate as an Autograft for Proximal Pole Scaphoid Fractures: Clinical Outcomes and Biomechanical Implications. Hand Clin 2019; 35:287-294. [PMID: 31178087 DOI: 10.1016/j.hcl.2019.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Scaphoid proximal pole fractures remain a surgical challenge because of high propensity for nonunion, osteonecrosis, and ultimately carpal collapse. Options for management of nonsalvageable proximal pole fractures include non-vascularized bone grafts, vascularized pedicled bone grafts, free vascularized bone flaps, and rib cartilage grafts. The proximal pole of the hamate can also serve as a replacement arthroplasty in the setting of proximal pole scaphoid nonunions with collapse, bone loss, and/or osteonecrosis. This novel graft addresses shortcomings of other graft choices by providing a local structural autograft solution with minimal donor site morbidity, correcting carpal collapse, reconstructing the scapholunate ligament, and mitigating the need for microvascular anastomosis.
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Izquierdo Ò, Aparicio P, Domínguez E, Castellanos J. Lunate Reconstruction Using Osteochondral Vascularized Graft in Kienböck's Disease. J Hand Microsurg 2018; 10:146-149. [PMID: 30483022 DOI: 10.1055/s-0038-1630144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 01/04/2018] [Indexed: 10/17/2022] Open
Abstract
There is a general consensus that the pathogenesis for Kienböck's disease remains uncertain, though it is probably related to nonphysiologic stress transmission across the lunate, acting in concert with one of several possible vascular abnormalities. Most surgical treatments focus on mechanical aspects rather than real physiopathology, but in the recent years several articles have shown the utility of vascularized grafts in the treatment of Kienböck's disease, especially in its early stages. The authors present a case of a successfully reconstruction of a IIIA stage Kienböck's disease with an osteochondral vascularized graft from medial femoral condyle.
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Affiliation(s)
- Òscar Izquierdo
- Upper Limb and Microsurgery Unit, Orthopaedics Department, Parc Sanitari Sant Joan de Déu de Sant Boi de Llobregat, Barcelona
| | - Pilar Aparicio
- Upper Limb and Microsurgery Unit, Orthopaedics Department, Parc Sanitari Sant Joan de Déu de Sant Boi de Llobregat, Barcelona
| | - Enric Domínguez
- Upper Limb and Microsurgery Unit, Orthopaedics Department, Parc Sanitari Sant Joan de Déu de Sant Boi de Llobregat, Barcelona
| | - Juan Castellanos
- Upper Limb and Microsurgery Unit, Orthopaedics Department, Parc Sanitari Sant Joan de Déu de Sant Boi de Llobregat, Barcelona
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Nakanishi A, Kawamura K, Omokawa S, Shimizu T, Tanaka Y. Reconstruction of a metacarpal head defect due to bite injury: two case reports. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2018; 5:62-67. [PMID: 30397633 PMCID: PMC6211214 DOI: 10.1080/23320885.2018.1509717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/05/2018] [Indexed: 12/02/2022]
Abstract
We present two rare cases of acute osteomyelitis after bite injury that were reconstructed with a third metacarpal base osteoarticular flap and a vascularised medial femoral trochlea osteocartilaginous flap. The outcomes show that a vascularised osteoarticular flap is a good treatment option for a metacarpal head defect.
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Affiliation(s)
- Akito Nakanishi
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Kenji Kawamura
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Shohei Omokawa
- Department of Hand Surgery, Nara Medical University, Nara, Japan
| | - Takamasa Shimizu
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
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Kaempf de Oliveira R, Delgado PJ, Ribak S, Bertelli JA, da Silva Marques F. Lunate Grafting Into the Radius for Lunate Fossa Reconstruction in Madelung Deformity. J Hand Surg Am 2018; 43:683.e1-683.e5. [PMID: 29510891 DOI: 10.1016/j.jhsa.2018.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 11/08/2017] [Accepted: 01/22/2018] [Indexed: 02/02/2023]
Abstract
A 40-year-old woman presented with Madelung deformity and severe arthritic changes at both the radiocarpal and the distal radioulnar joints. She was treated by using her lunate as an osteochondral graft into the radius allowing reconstruction of the lunate fossa. The scaphoid and triquetrum were removed concomitantly and a Sauve-Kapandji procedure was performed. Complete bone healing was achieved. Ten years later, an excellent functional result was maintained, with a pain-free wrist, an acceptable wrist joint range of motion, as well as a favorable aesthetic appearance. This procedure may be indicated for patients with severe Madelung deformity with painful radiocarpal and distal radioulnar joints associated with severe arthritis changes.
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Affiliation(s)
- Ricardo Kaempf de Oliveira
- Hand Surgery Department, Hospital Mãe de Deus, Porto Alegre, Brazil; Department of Hand Surgery, Hospital Santa Casa, Porto Alegre, Brazil.
| | - Pedro José Delgado
- Department of Hand and Upper Limb Surgery, Hospital Universitario Montepríncipe, Madrid, Spain
| | - Samuel Ribak
- Department of Hand Surgery, Hospital Nossa Senhora do Pari, São Paulo, Brazil; Department of Hand Surgery, Pontifícia Universidade Católica de Campinas, Campinas, Brazil
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Abstract
Treatment of intra-articular malunion of the distal radius has evolved over the past 20 years, from open treatment to wet then dry arthroscopic techniques that provide excellent results with less morbidity than open approaches. Dry wrist arthroscopy provides a well-visualized surgical space in treating intra-articular malunion and results in less edema than wet techniques. The best results are attained in the first 3 months after injury. Alternative methods for avoiding total wrist arthrodesis in those who present later have been developed. The dry arthroscopic "inside-out" osteotomy technique for intra-articular malunions should be considered in patients with this condition.
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11
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Baltzer HL, Moran SL. The Biomechanical Impact of Digital Loss and Fusion Following Trauma: Setting the Patient up for Success. Hand Clin 2016; 32:443-463. [PMID: 27712747 DOI: 10.1016/j.hcl.2016.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Surgeons managing mutilating hand injures are faced with difficult decisions between attempting to salvage remaining or injured digits or proceeding to amputation and fusion. Through application of a basic understanding of hand biomechanics, the surgeon may more accurately predict what motion and function can best be salvaged. This article provides an explanation of how amputation, fusion, and tendon loss can affect postoperative hand motion. The surgeon can use these concepts in planning the reconstruction or preparing the foundation for secondary reconstructive procedures to achieve the highest functional outcome for the patient.
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Affiliation(s)
- Heather L Baltzer
- Toronto Western Hand Program, University Health Network, University of Toronto, 399 Bathurst Street, 2nd Floor East Wing, Room 422, Toronto, Ontario M5T 2S8, Canada
| | - Steven L Moran
- Division of Orthopedic Surgery, Department of Hand Surgery, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA; Division of Plastic Surgery, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
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12
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Cavadas PC, Thione A, Martinez IE. Distal Ulna Reconstruction using the Second Metatarsal: Anatomical Study. J Wrist Surg 2016; 5:160-164. [PMID: 27104084 PMCID: PMC4838476 DOI: 10.1055/s-0036-1581051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 02/14/2016] [Indexed: 10/22/2022]
Abstract
Background The ulnar head is a key stabilizer of the wrist and forearm. The authors investigated the possibility of using the second metatarsal bone to replace the distal ulna in an anatomical study. Methods The morphology of the distal ulna and the head of the second metatarsal (MT2) were studied using three-dimensional computerized tomographic (CT) scans of the wrist and foot in 52 patients without pathology related to these two areas, and 11 cadaveric specimens. The radius and height of the best-fit cylinder for both epiphyses were measured in the CT scans and compared. In the cadaveric specimens an osteotomy of the metatarsal neck was performed to rotate 90 degrees the head of the MT2 to match the shape of the distal ulna. Results The osseous morphology of the distal ulna and the head of the MT2 are roughly cylindrical, but differently oriented relative to the diaphyseal axes. In the osteotomized cadaveric MT2specimens, the overall morphology was relatively similar that of the distal ulna. The mean length of the MT2 after the osteotomy was 65 mm. Conclusion The head of the MT2 was found to have a similar cylindrical morphology to that of the ulnar head, with a different orientation. The radius of the cylinder was similar, although the height was bigger for the MT2. After a rotation osteotomy of the neck of the MT2 the overall shape and orientation of the epiphysis was more similar to the distal ulna. A vascularized transfer of an osteotomized MT2 would be an option for autologous reconstruction of the distal ulna in selected patients, but further study is needed in terms of the vascular supply, ligamentous reconstruction, and reconstruction of the sigmoid notch. Level of Evidence Therapeutic, level IV.
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Distal Radius Joint Surface Reconstruction Using a Pedicle Pisiform Osteochondral Transfer. J Hand Surg Am 2015; 40:2075-80. [PMID: 26328901 DOI: 10.1016/j.jhsa.2015.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 04/25/2015] [Accepted: 07/22/2015] [Indexed: 02/02/2023]
Abstract
Treatment of a large articular cartilage defect in the distal radius poses a significant challenge to hand surgeons. To reduce the development of secondary degenerative arthritis, restoration of the articular surface is preferable. Pedicle pisiform transfer has been reported as a useful treatment option for Kienböck's disease. We describe a surgical technique involving vascularized pisiform transfer for large cartilage defects after intra-articular distal radius fractures and highlight the vascular supply of the pisiform.
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Houdek MT, Wagner ER, Wyles CC, Nanos GP, Moran SL. New options for vascularized bone reconstruction in the upper extremity. Semin Plast Surg 2015; 29:20-9. [PMID: 25685100 DOI: 10.1055/s-0035-1544167] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Originally described in the 1970s, vascularized bone grafting has become a critical component in the treatment of bony defects and non-unions. Although well established in the lower extremity, recent years have seen many novel techniques described to treat a variety of challenging upper extremity pathologies. Here the authors review the use of different techniques of vascularized bone grafts for the upper extremity bone pathologies. The vascularized fibula remains the gold standard for the treatment of large bone defects of the humerus and forearm, while also playing a role in carpal reconstruction; however, two other important options for larger defects include the vascularized scapula graft and the Capanna technique. Smaller upper extremity bone defects and non-unions can be treated with the medial femoral condyle (MFC) free flap or a vascularized rib transfer. In carpal non-unions, both pedicled distal radius flaps and free MFC flaps are viable options. Finally, in skeletally immature patients, vascularized fibular head epiphyseal transfer can provide growth potential in addition to skeletal reconstruction.
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Affiliation(s)
- Matthew T Houdek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Eric R Wagner
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Cody C Wyles
- School of Medicine, Mayo Clinic, Rochester, Minnesota
| | - George P Nanos
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Steven L Moran
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota ; Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
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Kodama N, Takemura Y, Imai S, Matsusue Y. New option for surgical treatment of the trapeziometacarpal osteoarthritis: a case report. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2015; 2:47-9. [PMID: 27252969 PMCID: PMC4793790 DOI: 10.3109/23320885.2015.1029483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 01/27/2015] [Accepted: 03/10/2015] [Indexed: 11/13/2022]
Abstract
We present the case of a 71-year-old, left-handed woman with left thumb carpometacarpal (CMC) joint arthritis. The patient had no pain and could use the hand actively in daily life with a new option of surgical treatment, a vascularized pedicled third CMC joint transfer to the thumb CMC joint.
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Affiliation(s)
- Narihito Kodama
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Yoshinori Takemura
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Shinji Imai
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Yoshitaka Matsusue
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan
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Marcuzzi A, Ozben H, Russomando A. Salvage of a post-traumatic arthritic wrist using the scaphoid as an osteochondral graft. ACTA ACUST UNITED AC 2014; 33:303-7. [PMID: 25034309 DOI: 10.1016/j.main.2014.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/10/2014] [Accepted: 04/26/2014] [Indexed: 10/25/2022]
Abstract
The authors describe a case of post-traumatic wrist arthritis with an osteochondral defect in the scaphoid fossa of the radius. The patient was treated with proximal row carpectomy, radial styloidectomy and reconstruction of the defect using the proximal half of the scaphoid as an autologous osteochondral graft. Pain relief was achieved while wrist motion and strength were improved. The carpal bones are a source of osteochondral grafts and can be used to expand the indications of motion-preserving wrist salvage procedures.
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Affiliation(s)
- A Marcuzzi
- Hand and Microvascular Unit, Azienda Ospedaliera Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy
| | - H Ozben
- Hand and Microvascular Unit, Azienda Ospedaliera Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy.
| | - A Russomando
- Hand and Microvascular Unit, Azienda Ospedaliera Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy
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