000			03899nam a22004817a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a0363-5023
024			_aS0363-5023(24)00198-9 [pii]
040			_aOvid MEDLINE(R)
099			_a38934986
245			_aMedial Femoral Trochlea Osteochondral Flap Reconstruction of the Previously Unsalvageable Kienbock-Associated Lunate With a Coronal Split.
251			_aJournal of Hand Surgery - American Volume. 2024 Jun 26
252			_aJ Hand Surg [Am]. 2024 Jun 26
253			_aThe Journal of hand surgery
260			_c2024
260			_fFY2024
260			_p2024 Jun 26
265			_saheadofprint
265			_tPublisher
266			_d2024-08-07
266			_z2024/06/27 10:33
501			_aAvailable in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present
520			_aCONCLUSIONS: Lunate coronal fracture fixation with MFT osteochondral reconstruction represents an additional management option in select patients with Kienbock disease. This technique restores the midcarpal joint during lunate reconstruction and may allow patients to avoid salvage procedures. Early radiographic and clinical outcomes are promising.
520			_aMETHODS: This was a retrospective study performed at a single institution. We identified patients with Kienbock disease who underwent MFT osteochondral reconstruction from 2014 to 2023. Patients were included if they had a coronal fracture of the lunate distal articular surface fixed at the time of surgery. Radiographic and clinical parameters were evaluated, including carpal height ratio, union rate, presence of heterotopic ossification, need for revision surgery, and patient-reported outcome measures.
520			_aPURPOSE: Patients with Kienbock disease can present with coronal fracture and collapse of the proximal lunate (Unified B2/Bain grade 1, 2B). Traditionally, this was considered unsalvageable. However, medial femoral trochlea (MFT) osteochondral reconstruction, used to recreate the proximal lunate surface, can be paired with reduction and repair of the coronal plane fracture, thus restoring midcarpal congruity. The purpose of this study was to report radiographic and clinical outcomes following lunate coronal fracture fixation at the time of MFT osteochondral reconstruction.
520			_aRESULTS: Thirty-three patients were included, with a mean age of 27.5 years (range: 15-41); 19 (58%) were women. Mean radiographic follow-up time was 5.8 months, and mean clinical follow-up time was 22.6 months. Union was achieved in 30/33 patients (91%). Carpal height ratio improved from 1.32 to 1.4. Two patients (6%) required reoperation, one for removal of heterotopic ossification and another for conversion to proximal row carpectomy. Patients demonstrated meaningful improvement in brief Michigan Hand Questionnaire and Patient-Reported Outcomes Measurement Information Upper Extremity scores. Range of motion before and after surgery was similar.
520			_aTYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV. Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
650			_zAutomated
651			_aCurtis National Hand Center
651			_aMedStar Union Memorial Hospital
656			_aOrthopaedic Surgery Residency
657			_aJournal Article
700			_aDahl, Amanda _bCURT
700			_aGiladi, Aviram M _bCURT
700			_aHiggins, James P _bCURT
700			_aImbergamo, Casey _bMUMH _cOrthopaedic Surgery Residency _dMD
700			_aMacaraeg, Crisanto _bCURT
790			_aImbergamo CM, Dahl A, Macaraeg C, Giladi AM, Higgins JP
856			_uhttps://dx.doi.org/10.1016/j.jhsa.2024.04.007 _zhttps://dx.doi.org/10.1016/j.jhsa.2024.04.007
942			_cART _dArticle
999			_c14371 _d14371