Comparison of Clinical Outcomes in Open and Arthroscopically-Assisted Mini Open Proximal Row Carpectomy for Lichtman Stage IIIB and IIIC Kienböck Disease

Degenerative wrist conditions, such as scapholunate advanced collapse and scaphoid nonunion advanced collapse, often require salvage procedures to reduce pain and improve function. For early stages of disease, both proximal row carpectomy and scaphoid excision four-corner arthrodesis are viable motion-preserving options. There remains controversy on which technique is superior. Selection is a nuanced decision that requires consideration of patient characteristics and stage of disease. The traditional notion that proximal row carpectomy should be reserved for older individuals with low demands has been challenged; long-term studies in younger populations demonstrate similar patient-reported outcomes, pain relief and survivorship without conversion to total wrist arthrodesis between proximal row carpectomy and four-corner arthrodesis. The existing evidence suggests proximal row carpectomy has advantages of greater range of motion, fewer complications and lower costs. Advancements such as arthroscopic techniques for both procedures show potential, although mastery involves a steep learning curve.

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The Efficacy of Surgical Treatment for Kienböck’s Disease with 4-5 ECA Pedicled Osseous Flap: A Retrospective Study

Özdemir

Ergin

Ertaş

et al. 2023

Genel Tıp Dergisi

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Aim: The aim of this retrospective study is to assess the effectiveness of surgical intervention for Kienböck's disease using 4-5 Extensor Compartmental Artery (4-5 ECA) pedicled osseous flap Method: Patients who underwent 4-5 ECA pedicled bone grafts for Kienböck's disease between January 2012 and January 2022 were included in the study. The patient files were analyzed retrospectively for age, gender, follow-up time, and complications. Disease staging was performed preoperatively using direct X-ray and MRI, and radiological improvement was evaluated postoperatively using radiography. The functional and clinical assessment was made by comparing preoperative and postoperative VAS, Q-Dash, and Mayo scores. Results: This study involved 23 patients (12 female and 11 male) with Kienböck's disease who underwent 4-5 ECA pedicled bone graft surgery. 13 cases were right-handed while 10 were left-handed. The mean age was 37.5 ± 12.5 years, and the mean follow-up time was 68 months. The mean preoperative Q-Dash score was 78.8 (± 9), the VAS score was 6.5 (±1.2, and the Mayo wrist score was 34.34 (±11.8). The mean postoperative Q-Dash score was 33.1( ±10), the VAS score was 2.4 (±1.7), and the Mayo wrist score was 73.9 (±14.5). The differences between preoperative and postoperative Q-DASH scores (p

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Comparison of Clinical Outcomes in Open and Arthroscopically-Assisted Mini Open Proximal Row Carpectomy for Lichtman Stage IIIB and IIIC Kienböck Disease

Cited by 3 publications

References 28 publications

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Proximal row carpectomy or scaphoid excision and four-corner arthrodesis for treatment of scapholunate advanced collapse arthritis

The Efficacy of Surgical Treatment for Kienböck’s Disease with 4-5 ECA Pedicled Osseous Flap: A Retrospective Study

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