Medial femoral trochlea flap reconstruction versus proximal row carpectomy for Kienbock's disease: a morphometric comparison.

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Citation: Journal of Hand Surgery: European Volume. 46(10):1042-1048, 2021 12.PMID: 34289733Institution: Curtis National Hand CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Capitate Bone | *Carpal Bones | *Lunate Bone | *Osteonecrosis | Femur/dg [Diagnostic Imaging] | Femur/su [Surgery] | Humans | Lunate Bone/dg [Diagnostic Imaging] | Lunate Bone/su [Surgery] | Osteonecrosis/dg [Diagnostic Imaging] | Osteonecrosis/su [Surgery] | Surgical FlapsYear: 2021ISSN:
  • 0266-7681
Name of journal: The Journal of hand surgery, European volumeAbstract: Surgical options for advanced Kienbock's disease include proximal row carpectomy or lunate reconstruction with a medial femoral trochlea osteochondral flap. This study compares morphology of the proximal capitate and the medial femoral trochlear surfaces to the proximal lunate using three-dimensional geometric morphometric analysis. Virtual articular surfaces were extracted from MRI studies of ten healthy volunteers. Distances between corresponding points on the proximal lunate and proximal capitate or medial femoral trochlear surfaces were measured. In seven subjects, mean inter-surface distance for the medial femoral trochlea-proximal lunate pair was significantly lower than the proximal capitate-proximal lunate pairing. In three subjects, mean proximal capitate-proximal lunate distance was significantly lower. We conclude that the medial femoral trochlear flap was anatomically closer to the shape of the proximal lunate in the majority of the examined subjects. However, we found that in three out of ten cases, the proximal capitate was a better match.All authors: Allen KL, Daruwalla JH, Higgins JP, Lynch LM, Pet MA, Van Handel ACOriginally published: Journal of Hand Surgery: European Volume. 46(10):1042-1048, 2021 Dec.Fiscal year: FY2022Fiscal year of original publication: FY2022Digital Object Identifier: ORCID: Date added to catalog: 2021-11-01
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Journal Article MedStar Authors Catalog Article 34289733 Available 34289733

Surgical options for advanced Kienbock's disease include proximal row carpectomy or lunate reconstruction with a medial femoral trochlea osteochondral flap. This study compares morphology of the proximal capitate and the medial femoral trochlear surfaces to the proximal lunate using three-dimensional geometric morphometric analysis. Virtual articular surfaces were extracted from MRI studies of ten healthy volunteers. Distances between corresponding points on the proximal lunate and proximal capitate or medial femoral trochlear surfaces were measured. In seven subjects, mean inter-surface distance for the medial femoral trochlea-proximal lunate pair was significantly lower than the proximal capitate-proximal lunate pairing. In three subjects, mean proximal capitate-proximal lunate distance was significantly lower. We conclude that the medial femoral trochlear flap was anatomically closer to the shape of the proximal lunate in the majority of the examined subjects. However, we found that in three out of ten cases, the proximal capitate was a better match.

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