Naett R, Nonnenmacher J, Copin G
Handchirurgie. 1981;13(3-4):212-7.
Graner's intercarpal arthrodesis was performed in 10 patients with Kienböck's disease. The procedure consists in excision of the deformed lunate bone, cartilage resection in the adjacent intercarapal joints (Fig. 5), transverse osteotomy of the capitate bone, transposition of its proximal part to the place of the lunate, fixation with Kirschner wires and filling all the remaining bone spaces with cancellous bone. Postoperative immobilisation was necessary for about three months. Eight of these patients were reviewed 1 to 4 years postoperatively. 40% were free of pain, 50% have some pain and 10% moderate to severe pain. The range of motion in the wrist was restricted between one and two thirds, the strength of the grip on average was one third of the normal values. Severe arthrotic changes were considered as contraindications for this procedure, because their further development was no stopped by the intercarpal arthrodesis and will interfere with the positive aspects of this procedure.
对10例月骨无菌性坏死患者施行了格拉纳腕骨间关节融合术。该手术包括切除畸形的月骨、切除相邻腕骨间关节的软骨(图5)、对头状骨进行横向截骨、将其近端移位至月骨位置、用克氏针固定并用松质骨填充所有剩余骨间隙。术后需固定约三个月。其中8例患者在术后1至4年接受了复查。40%的患者无痛,50%的患者有一些疼痛,10%的患者有中度至重度疼痛。腕关节活动范围受限在三分之一至三分之二之间,平均握力为正常值的三分之一。严重的关节病变被视为该手术的禁忌证,因为腕骨间关节融合术无法阻止其进一步发展,且会干扰该手术的积极效果。