Coronal Fracture of the Lunate in Advanced Kienbock Disease: Reestablishing Midcarpal Congruency to Enable Osteochondral Reconstruction: A Case Report. 

 -  2018 
<br/><br/> CASE: We describe a patient with Bain grade-2b Kienbock disease with a coronal fracture of the distal lunate articular surface with proximal structure collapse. To reestablish midcarpal congruity, we used a bone-anchored suture to repair the coronal split in the lunate in preparation for lunate preservation with osteochondral medial femoral trochlea (MFT) reconstruction.  CONCLUSION: In Bain grade-2b Kienbock disease, lunate reconstruction of both the proximal and distal joint surfaces can be performed. Successful reconstruction of the distal articular surface can be achieved using a bone-anchored FiberWire (Arthrex) suture technique. This can be employed in conjunction with an osteochondral MFT reconstruction of the proximal aspect of the lunate. Patients with this commonly encountered coronal fracture of the distal articular surface may be considered candidates for lunate reconstruction via this technique rather than conventional ablative procedures. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>2160-3251 
<br/><br/><label>Standard No.: </label>10.2106/JBJS.CC.17.00254 [doi] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>IN PROCESS -- NOT YET INDEXED
<br/><br/><label>Subjects--Geographic Terms: </label><br/>Curtis National Hand Center
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article