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The Scientific World Journal
Volume 2013 (2013), Article ID 416246, 5 pages
http://dx.doi.org/10.1155/2013/416246
Research Article

Tendon Interposition and Ligament Reconstruction with ECRL Tendon in the Late Stages of Kienböck’s Disease: A Cadaver Study

1Department of Orthopaedics and Traumatology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
2Department of Anatomy, School of Medicine, Ankara University, Ankara, Turkey
3Department of Orthopaedics and Traumatology, School of Medicine, Ankara University, Ankara, Turkey
4Department of Engineering Sciences, Experimental Mechanics and Biomechanics Laboratory, Middle East Technical University, Ankara, Turkey
5Department of Plastic and Reconstructive Surgery, Ankara Training and Research Hospital, Ankara, Turkey

Received 5 February 2013; Accepted 10 March 2013

Academic Editors: Y. K. Tu and O. Wahlstrom

Copyright © 2013 Nazım Karalezli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The optimal surgical treatment for Kienböck’s disease with stages IIIB and IV remains controversial. A cadaver study was carried out to evaluate the use of coiled extensor carpi radialis longus tendon for tendon interposition and a strip obtained from the same tendon for ligament reconstruction in the late stages of Kienböck’s disease. Methods. Coiled extensor carpi radialis longus tendon was used to fill the cavity of the excised lunate, and a strip obtained from this tendon was sutured onto itself after passing through the scaphoid and the triquetrum acting as a ligament to preserve proximal row integrity. Biomechanical tests were carried out in order to evaluate this new ligamentous reconstruction. Results. It was biomechanically confirmed that the procedure was effective against axial compression and distributed the upcoming mechanical stress to the distal row. Conclusion. Extensor carpi radialis longus tendon has not been used for tendon interposition and ligament reconstruction in the treatment of this disease before. In view of the biomechanical data, the procedure seems to be effective for the stabilization of scaphoid and carpal bones.