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Capitate Shortening for Kienböck’s Disease

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Kienböck’s Disease

Abstract

Capitate shortening osteotomy is a simple and straightforward procedure that has gained interest in recent years. It is indicated if the lunate is intact and the articular surfaces of the lunate or adjacent articulations are functional. It is contraindicated if the lunate is fragmented or if the articular surfaces are not functional. Therefore the decision to perform a capitate-shortening osteotomy is based on assessment of the lunate and articular surfaces of the carpus, with preoperative imaging and intraoperative examination.

Capitate-shortening osteotomy effectively decreases the load transfer across the lunate and creates a regional hyperemia to promote healing. Therefore, capitate-shortening osteotomy has both mechanical and biological healing effects on the lunate and the wrist. Unlike radial shortening, it can be used regardless of ulnar variance, and does not compromise the distal radioulnar joint. Assessment of cumulative data demonstrates that the majority of patients who have a capitate-shortening osteotomy will have improvement in their pain, grip strength, and range of motion. There are no reports of nonunion or avascular necrosis of the capitate.

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Author information

Authors and Affiliations

  1. Department of Orthopedics, Urmia University of Medical Sciences, Imam Khomeini Hospital, Modaress Street, Ershad Boulevard, Urmia, West Azarbaijan, 57157-81351, Iran

    Ahmadreza Afshar MD

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  1. Ahmadreza Afshar MD
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Correspondence to Ahmadreza Afshar MD .

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Editors and Affiliations

  1. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

    David M. Lichtman

  2. Department of Orthopedic Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia

    Gregory Ian Bain

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Afshar, A. (2016). Capitate Shortening for Kienböck’s Disease. In: Lichtman, D., Bain, G. (eds) Kienböck’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-34226-9_15

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  • DOI: https://doi.org/10.1007/978-3-319-34226-9_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34224-5

  • Online ISBN: 978-3-319-34226-9

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