Long-term results after vascularised bone graft as treatment of Kienböck disease.

The aim of this study was to present the long-term results in a small series of patients with Kienböck disease treated with a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as the only surgical treatment. In the period 2002-2006, five patients, three men and two women, mean age 41 years (22-54) were operated on using a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as described by Sheetz et al. Four patients were staged as Lichtman stage 2 and one as Lichtman stage 3. At the follow-up examination with radiographs and clinical examination at a mean of 7.4 years (5-9) after the operation, they all stated that they were satisfied with the operation. None of the patients had any further surgery in the observation period. Four patients were fully employed, and only one had changed employment due to his hand. The last patient was on a medical pension due to other medical causes. In all patients, no sign of progression was found of the radiological changes in the lunate and in all patients the arches of Gilula were unchanged without signs of carpal collapse. So, in this small series, a pedicled vascularised bone graft from the 4/5 extensor compartment of the distal radius as the only surgical treatment provided good long-term results in patients with stage 2 and 3 Kienböck disease.