[Results of vascular pedicled bone transposition in advanced necrosis of the lunate bone]

Beck (1971) recommended transposition of the pisiform bone into the lunate bone for treatment of lunatomalacia in stage I. In the period from 1979 to 1983, this operation was carried out in 12 patients with lunatomalacia in the Orthopaedic Division, University of Heidelberg-Schlierbach. The operation was carried out in five patients with stage II, six patients with stage III and in one patient with stage IV. In five patients, the operation was carried out in combination with shortening of the radius and in one patient in combination with wrist denervation. The transponants healed in all patients. However, restoration of the bone structure and the form of the lunate bone could only be attained after radius shortening. Special attention must be paid to the variance of the forearm bones in selecting the correct procedure in lunatomalacia.