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[Prosthetic replacement of the semilunar bone]
M Merle1, D Memeteau, J Michon
1Service Assistance Main, CHU.Nancy, Hôpital Jeanne d'Arc, Dommartinles-Toul.
Annales De Chirurgie De La Main : Organe Officiel Des Societes De Chirurgie De La Main
|January 1, 1982
Summary
Lunate prostheses can improve wrist pain and mobility in osteonecrosis patients, but dislocation is a risk. Results show poor grip strength, necessitating careful consideration for manual laborers.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Biomedical engineering
Context:
- Osteonecrosis of the lunate, specifically Stage III (Decoulx classification), presents significant challenges.
- Traditional treatments may not fully restore function, leading to exploration of prosthetic solutions.
Purpose:
- To evaluate the efficacy and complications of lunate prostheses in treating advanced osteonecrosis.
- To assess functional outcomes, including pain, mobility, and grip strength, post-implantation.
Summary:
- Twenty-two lunate prostheses were implanted using a palmar approach, with dorsal incisions for ligament repair as needed. Immobilization lasted six weeks.
- The primary complication was dislocation (5 cases), attributed to capsular weakness, poor implant fit, or inadequate immobilization.
- While pain decreased and mobility improved, grip strength remained suboptimal, with 50% of patients achieving good or excellent results.
Impact:
- Lunate prostheses offer a potential treatment for lunate osteonecrosis, improving pain and range of motion.
- The risk of dislocation and persistent poor grip strength necessitates careful patient selection, especially for manual laborers.
- Over 30% of manual laborers required a job change post-surgery, highlighting the functional limitations and impact on vocational activities.