Idiopathic Avascular Necrosis of the Capitate Treated with a Medial Femoral Trochlea Vascularized Osteochondral Flap: A Case Report.
| Autor: | Kozusko SD; Department of Orthopedic Surgery, University of Virginia, Charlottesville, Virginia., Hassebrock JD, Chhabra AB, Freilich AM, DeGeorge BR |
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| Jazyk: | angličtina |
| Zdroj: | JBJS case connector [JBJS Case Connect] 2024 Apr 26; Vol. 14 (2). Date of Electronic Publication: 2024 Apr 26 (Print Publication: 2024). |
| DOI: | e23.00555 |
| Abstrakt: | Case: Capitate avascular necrosis should be entertained in a differential diagnosis of young, active adults with midcarpal wrist pain. We present a case study of a 30-year-old laborer who developed avascular necrosis (AVN) of his right proximal capitate. Grip strength and wrist motion were limited on examination, with advanced imaging confirming AVN. A diagnostic arthroscopy confirmed the pathology. Treatment was completed with a medial femoral trochlea vascularized flap for cartilaginous resurfacing. At 10-month follow-up, the patient's capitate was healed with stable fixation, and he is working full-time as a laborer without restrictions. Conclusion: AVN of the capitate is a unique and challenging articular pathology that requires a thoughtful preoperative evaluation and meticulous surgical technique to reconstruct. The medial femoral trochlea (MFT) vascularized bone transfer with cartilaginous resurfacing is 1 available treatment option. This flap is harvested from the medial femur using microsurgical techniques, based on the descending genicular artery. Using a 2-surgeon approach, simultaneous dissection of the AVN is completed at the wrist. This flap is a vascularized option that can be used for both AVN and nonunion with structural deformity before salvage surgeries. Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C320). (Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.) |
| Databáze: | MEDLINE |
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