The Carpal Collapse: Kienböck’s Disease: Advances in Diagnosis and Treatment
Kienböck’s disease is a devastating, insidious condition where the blood supply to the lunate—the central keystone bone of the wrist—is mysteriously interrupted. The bone dies (avascular necrosis), fractures, and collapses, leading to a profound biomechanical cascade that destroys the entire radiocarpal joint. Kienböck’s Disease: Advances in Diagnosis and Treatment is a fiercely focused, highly specialized surgical manual dedicated entirely to this enigmatic pathology. This volume provides the exact blueprints required to intercept the vascular failure and salvage the wrist.
Mastering Staging and Biomechanics
The core philosophy of this text is intervention based on mechanical stage. The authors aggressively detail the Lichtman classification system. It dictates exactly how to utilize high-resolution MRI to identify early (Stage I/II) ischemic changes before structural collapse occurs, and how to assess “ulnar variance” (the relative length of the radius and ulna) to understand the abnormal forces crushing the lunate.
Navigating Joint Leveling and Vascularized Grafts
The book provides a masterclass in wrist reconstruction. It dictates the exact surgical pathways for early-stage disease, detailing joint-leveling procedures (like a radial shortening osteotomy) to decompress the dying lunate. It rigorously covers the highly complex microvascular techniques required to implant a vascularized bone graft (e.g., from the distal radius) directly into the lunate, attempting to re-establish blood flow before the bone turns to dust.
Frequently Asked Questions (FAQs)
Does this book cover late-stage salvage procedures?
Yes, it exhaustively details the salvage operations for Stage IV (collapsed) disease, including proximal row carpectomy (PRC) and partial or total wrist fusion (arthrodesis).
Who is the primary audience?
It is the absolute, mandatory surgical atlas for Orthopedic Hand Surgeons, Plastic/Microvascular Surgeons, and Upper Extremity Specialists.
