JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Management of early-stage Kienböck disease (stages 1–3a) with vascularized bone grafting
Abstract
Aims: Kienböck’s disease is characterized by avascular necrosis of the lunate, with its etiology still debated. Vascularized bone grafting (VBG) has emerged as a surgical option for early-stage disease to improve vascularity and preserve carpal function. This study aimed to evaluate clinical and functional outcomes of stage 1–3A Kienböck’s disease treated with a pedicled VBG based on the 4th and 5th extensor compartment arteries (ECAs). Methods: This retrospective cohort included 22 patients (7 stage 1, 9 stage 2, 6 stage 3A) treated between 2017 and 2023. Surgical technique involved harvesting a corticospongious graft from the distal radius, transferred on the 4+5 ECA pedicle into the lunate defect. Postoperatively, a short-arm splint was applied for 4–6 weeks, followed by physiotherapy. Outcomes were assessed preoperatively and at 12 months: wrist flexion–extension arc, ulnar–radial deviation, grip strength, Visual Analog Scale (VAS, 0–100), and QuickDASH. Paired comparisons were performed with the paired T-test or Wilcoxon signed-rank test; comparisons among disease stages (stage 1, stage 2, and stage 3A) were performed using the Kruskal–Wallis test. Results: At one year, patients demonstrated significant improvements: flexion–extension arc (90.05°›128.00°, p

Keywords : Kienböck, lunate, avascular necrosis, 4+5 extensor compartment

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Article available in :
Volume 9, Issue 1, 2026
Page : 228-233
https://doi.org/10.32322/jhsm.1827790
Article Information
Received : 21 Kas 2025
Accepted : 31 Ara 2025
Published : 05 Oca 2026
Corresponding Author :

Zafer Güneş: Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkiye

[email protected]
Citation : Güneş Z, Erdoğan E. Management of early-stage Kienböck disease (stages 1–3a) with vascularized bone grafting. J Health Sci Med. 2026;9(1):228-233. doi:10.32322/jhsm.1827790

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