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Matching Kienböck's Treatment Options to Specific Features of Each Case

Kienböck's disease is best understood as a continuous interaction between compromised perfusion and structural deterioration that transitions from an early phase to a late phase. Existing literature has failed to identify any one superior treatment for Kienböck's; many studies even demonst...

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Autores principales: Henry, Mark, Lundy, Forrest H., Henry, Giselle K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070007/
https://www.ncbi.nlm.nih.gov/pubmed/37020608
http://dx.doi.org/10.1055/s-0041-1730888
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author Henry, Mark
Lundy, Forrest H.
Henry, Giselle K.
author_facet Henry, Mark
Lundy, Forrest H.
Henry, Giselle K.
author_sort Henry, Mark
collection PubMed
description Kienböck's disease is best understood as a continuous interaction between compromised perfusion and structural deterioration that transitions from an early phase to a late phase. Existing literature has failed to identify any one superior treatment for Kienböck's; many studies even demonstrate no advantage for surgery compared with the natural history. Surgical interventions for early and transitional Kienböck's are designed to preserve or reconstruct the lunate. However, in most studies, the only tool used to assess the lunate itself has been plain radiography that neither reveals critical architectural details (demonstrated by computed tomographic scan) nor the vascular status (demonstrated by magnetic resonance imaging). Most articles, therefore, do not adequately define the preoperative status of the lunate or its alteration through surgical intervention. Critical preoperative features that are best demonstrated by these advanced imaging studies have specific anatomic and physiologic relationships that better correspond with certain surgical interventions, which also pair better with specific patient characteristics. This review explains how to identify, analyze, and strategically match these variables with the treatment interventions available for Kienböck's patients through the early, transitional, and late phases of the disease.
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spelling pubmed-100700072023-04-04 Matching Kienböck's Treatment Options to Specific Features of Each Case Henry, Mark Lundy, Forrest H. Henry, Giselle K. J Hand Microsurg Kienböck's disease is best understood as a continuous interaction between compromised perfusion and structural deterioration that transitions from an early phase to a late phase. Existing literature has failed to identify any one superior treatment for Kienböck's; many studies even demonstrate no advantage for surgery compared with the natural history. Surgical interventions for early and transitional Kienböck's are designed to preserve or reconstruct the lunate. However, in most studies, the only tool used to assess the lunate itself has been plain radiography that neither reveals critical architectural details (demonstrated by computed tomographic scan) nor the vascular status (demonstrated by magnetic resonance imaging). Most articles, therefore, do not adequately define the preoperative status of the lunate or its alteration through surgical intervention. Critical preoperative features that are best demonstrated by these advanced imaging studies have specific anatomic and physiologic relationships that better correspond with certain surgical interventions, which also pair better with specific patient characteristics. This review explains how to identify, analyze, and strategically match these variables with the treatment interventions available for Kienböck's patients through the early, transitional, and late phases of the disease. Thieme Medical and Scientific Publishers Pvt. Ltd. 2021-06-19 /pmc/articles/PMC10070007/ /pubmed/37020608 http://dx.doi.org/10.1055/s-0041-1730888 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Henry, Mark
Lundy, Forrest H.
Henry, Giselle K.
Matching Kienböck's Treatment Options to Specific Features of Each Case
title Matching Kienböck's Treatment Options to Specific Features of Each Case
title_full Matching Kienböck's Treatment Options to Specific Features of Each Case
title_fullStr Matching Kienböck's Treatment Options to Specific Features of Each Case
title_full_unstemmed Matching Kienböck's Treatment Options to Specific Features of Each Case
title_short Matching Kienböck's Treatment Options to Specific Features of Each Case
title_sort matching kienböck's treatment options to specific features of each case
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070007/
https://www.ncbi.nlm.nih.gov/pubmed/37020608
http://dx.doi.org/10.1055/s-0041-1730888
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