Dorsal Capsular-based Vascularized Distal Radius Graft for Advanced Kienböck's Disease

Description

In this detailed surgical recording, John Capelle discusses a procedure to treat a patient with Kienböck's disease by performing a vascularized bone graft to tackle avascular necrosis of the lunate bone. The surgery begins with a longitudinal incision over the radiocarpal joint. The EPL tendon is identified, released, and retracted for protection during the operation. The surgeon continues to mobilize key tendons and prepares for accessing the wrist capsule to elevate a pedicle for the bone graft operation. The graft will be harvested from the radius, utilizing a k-wire for precision placement within the lunate bone while ensuring the preservation of vital joint structures. Following the graft harvesting, cancellous bone will be used to fill the debrided area of the lunate, to be sealed with the vascularized graft. Capelle details meticulous techniques for ensuring appropriate graft vascularity during the placement and stabilizes the graft with sutures and plates to secure proper healing. Throughout the video, he emphasizes the importance of maintaining blood supply to the graft and ensuring a robust surgical technique to avoid complications.

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