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Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The description is that of avascular necrosis of the lunate bone. The usual age of onset in this condition is 20–40 years. The condition is associated with negative ulnar variance. Blount disease is avascular necrosis of the medial tibial condyle, usually affecting patients over 6 years age. Freiberg disease typically affects the head of the second metatarsal. Sometimes the third or fourth metatarsal may be affected. Köhler disease is avascular necrosis of the navicular in patients 3–10 years old, more common in boys. Preiser disease is non-traumatic osteonecrosis of the scaphoid.
Vascularized bone graft from the second metacarpal base for trapeziometacarpal joint arthrodesis
Published in Case Reports in Plastic Surgery and Hand Surgery, 2018
Akito Nakanishi, Kenji Kawamura, Shohei Omokawa, Takamasa Shimizu, Yasuhito Tanaka
Hori et al. reported successful blood vessel transfer to necrotic bone using a dorsal metacarpal artery and veins in Kienböck disease and Preiser disease [1]. Furthermore, satisfactory clinical results have been reported using a vascularized second metacarpal base bone graft for the treatment of scaphoid nonunion and Kienböck disease [2]. Sawaizumi et al. modified this procedure, and performed this graft from the palmar side for scaphoid nonunion accompanied by dorsal intercalated segment instability [3–4]. However, there are no previous reports on the application of this procedure in patients with trapeziometacarpal (TMC) osteoarthritis. We used this procedure in patients with nonunion after failed arthrodesis of the TMC joint or with TMC osteoarthritis and severe osteoporosis. The purpose of the present article was to introduce the procedure of TMC joint arthrodesis using a vascularized bone graft based on the second metacarpal artery and veins, and to assess the clinical and radiological outcomes in three cases.