Free medial femoral condyle osteocutaneous flap for repairing stage IIIB osteonecrosis of the lunate: a case report.
Case report
Hand surgery
Medial femoral condyle osteocutaneous flap
Osteonecrosis of the lunate
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
30 Jul 2024
30 Jul 2024
Historique:
received:
20
07
2023
accepted:
19
07
2024
medline:
31
7
2024
pubmed:
31
7
2024
entrez:
30
7
2024
Statut:
epublish
Résumé
There are several surgical options for osteonecrosis of the lunate, and confirming the effectiveness of various surgical methods remains challenging. Here, we present a case of stage IIIB osteonecrosis of the lunate repaired with a free medial femoral condyle osteocutaneous flap. A 43-year-old male construction worker was admitted to our hospital due to right wrist pain, impaired mobility, and pain aggravated by activity for 10 months. The patient was diagnosed with stage IIIB osteonecrosis of the lunate based on the orthopantomogram and magnetic resonance imaging of the right wrist. Considering the patient's medical history, physical examination, auxiliary examination, and wishes, reconstruction was performed using a free medial femoral condyle osteocutaneous flap. After the flap survived completely, the K-wires were removed one month after the operation, the external brace was removed two months after the operation, and functional wrist rehabilitation was initiated. After six months of follow-up, the wrist swelling and pain resolved, and the reconstructed lunate bone was viable. Additionally, the last follow-up was conducted in the sixth month after surgery; the affected hand grip strength improved from about 70% (28 kg) to 80% (32 kg) compared with the healthy side (40 kg); the visual analog scale score decreased from 6.5 points before the operation to 1 point; and the MAYO score increased from 60 points before the operation to 85 points. The success of this case reinforces the potential of the free medial femoral condyle osteocutaneous flap as a new treatment option for stage IIIB osteonecrosis of the lunate and further expands the existing treatment options. Using a free medial femoral condyle osteocutaneous flap to reconstruct the lunate and restore the carpal anatomy may.
Sections du résumé
BACKGROUND
BACKGROUND
There are several surgical options for osteonecrosis of the lunate, and confirming the effectiveness of various surgical methods remains challenging. Here, we present a case of stage IIIB osteonecrosis of the lunate repaired with a free medial femoral condyle osteocutaneous flap.
CASE PRESENTATION
METHODS
A 43-year-old male construction worker was admitted to our hospital due to right wrist pain, impaired mobility, and pain aggravated by activity for 10 months. The patient was diagnosed with stage IIIB osteonecrosis of the lunate based on the orthopantomogram and magnetic resonance imaging of the right wrist. Considering the patient's medical history, physical examination, auxiliary examination, and wishes, reconstruction was performed using a free medial femoral condyle osteocutaneous flap. After the flap survived completely, the K-wires were removed one month after the operation, the external brace was removed two months after the operation, and functional wrist rehabilitation was initiated. After six months of follow-up, the wrist swelling and pain resolved, and the reconstructed lunate bone was viable. Additionally, the last follow-up was conducted in the sixth month after surgery; the affected hand grip strength improved from about 70% (28 kg) to 80% (32 kg) compared with the healthy side (40 kg); the visual analog scale score decreased from 6.5 points before the operation to 1 point; and the MAYO score increased from 60 points before the operation to 85 points.
CONCLUSIONS
CONCLUSIONS
The success of this case reinforces the potential of the free medial femoral condyle osteocutaneous flap as a new treatment option for stage IIIB osteonecrosis of the lunate and further expands the existing treatment options. Using a free medial femoral condyle osteocutaneous flap to reconstruct the lunate and restore the carpal anatomy may.
Identifiants
pubmed: 39080622
doi: 10.1186/s12891-024-07720-7
pii: 10.1186/s12891-024-07720-7
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
603Subventions
Organisme : Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma
ID : 2020Y2014
Organisme : Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma
ID : 2020Y2014
Organisme : Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma
ID : 2020Y2014
Organisme : Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma
ID : 2020Y2014
Organisme : Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma
ID : 2020Y2014
Organisme : Natural Science Foundation of Fujian Province
ID : 2022J011315
Organisme : Natural Science Foundation of Fujian Province
ID : 2022J011315
Organisme : Natural Science Foundation of Fujian Province
ID : 2022J011315
Organisme : Natural Science Foundation of Fujian Province
ID : 2022J011315
Organisme : Natural Science Foundation of Fujian Province
ID : 2022J011315
Informations de copyright
© 2024. The Author(s).
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