Early results of partial capitate shortening osteotomy in management of Kienböck disease

Singer, Mohamed Salah; Essawy, Osama M.; Farag, H.E.

doi:10.1097/bco.0000000000000492

Cited by 7 publications

(15 citation statements)

References 17 publications

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“…Weighted mean grip strength as a percentage of the contralateral side was obtainable for most studies; capitate shortening osteotomy: 68.0% (three studies, n ¼ 26) 21,23,24 ; radial shortening osteotomy: 75.2% (four studies, n ¼ 35) 21,22,25,30 ; VBG: 88.2% (five studies, n ¼ 45) 13,22,27,28,31 ; PRC: 70.0% (two studies, n ¼ 17). 19,29 Ten studies showed grip strength improvement, while 11 did not report preoperative grip strength and 1 had incomplete data.…”

Section: Stage-iiia Resultsmentioning

confidence: 98%

“…Weighted mean VAS for patients who underwent capitate shortening osteotomy was 3.2 (three studies, n ¼ 26). 21,23,24 Despite heterogeneous pain reporting for radial shortening osteotomy, there were seven patients who were pain free, 19 had mild pain, and 1 had moderate pain at final follow-up (four studies, n ¼ 27). 21,22,25,26 VBG pain scores were also heterogeneous.…”

Section: Stage-iiia Resultsmentioning

confidence: 99%

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Treatment of Stages IIIA and IIIB in Kienbock's Disease: A Systematic Review

et al. 2020

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Background Despite numerous proposed surgical interventions, there is a lack of consensus in the optimal treatment of advanced Kienbock's disease. Purpose This study aims to perform a systematic review of the current evidence in the management of Lichtman's stages IIIA and IIIB of the disease. Methods A literature search was performed using the MEDLINE, EMBASE, and COCHRANE databases to identify studies between 2008 and 2018 evaluating stage-specific outcomes in Lichtman's stages IIIA and IIIB. The quality of each included paper was evaluated using the Structured Effectiveness Quality Evaluation Scale (SEQES). Data extracted were stage-specificity, clinical and functional outcomes, and radiographic progression of Lichtman's staging. Results A total of 1,489 titles were identified. Eighty-three papers were fully reviewed, and 30 articles met eligibility criteria for inclusion. There were 3 low-quality and 27 moderate-quality papers. Surgical techniques reported included decompression surgeries, joint-levelling, and radial wedge osteotomies, revascularization techniques, intracarpal arthrodesis, proximal row carpectomy, arthroplasty, and balloon kyphoplasty. All treatment modalities offered pain relief and improvement in functional outcomes. Compared with proximal row carpectomy, intracarpal arthrodesis, and arthroplasty, nonsalvage procedures provided similar clinical and functional outcomes in both stages, with joint-levelling and radial wedge osteotomies preserving greater range of motion. Conclusion In this systematic review of Kienbock's disease stages IIIA and IIIB, all treatment modalities provided positive outcomes. In stage IIIB, there is evidence to support nonsalvage procedures, as they produced similar clinical outcomes to salvage procedures that have the advantage of not precluding future treatment options if needed and preserving greater range of motion.

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Section: Stage-iiia Resultsmentioning

confidence: 98%

Section: Stage-iiia Resultsmentioning

confidence: 99%

Treatment of Stages IIIA and IIIB in Kienbock's Disease: A Systematic Review

et al. 2020

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“…2). [31][32][33][34] Capitate Shortening Almquist 19 recommended capitate shortening for Kienbock's disease in ulnar positive wrists. Various techniques have been reported and are presented in ►Table 1.…”

Section: Fixation Optionsmentioning

confidence: 99%

“…However, patients with a lower Lichtman grade did have better outcomes. [32][33][34][35] Single-Cut Single-Screw Capitate-Shortening Osteotomy…”

Section: Fixation Optionsmentioning

confidence: 99%

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Single-Cut Single-Screw Capitate-Shortening Osteotomy for Kienbock's Disease

et al. 2020

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Background Kienbock's disease, in spite of an uncertain natural history, is known to cause lunate compromise, leading to central column collapse, carpal instability, and degenerative arthritis of the wrist. Joint leveling procedures are performed in the early stages of Kienbock's disease to “unload” the lunate. Capitate shortening is the preferred procedure in Kienbock's patients with positive ulnar variance. Description of Technique We describe the rationale and a simplified technique of capitate shortening in early Kienbock's disease. This is a single-cut osteotomy with single-screw stabilization. Patients and Methods We have performed this technique in three cases. We present a case of a 26-year-old male who presented with a 1-year history of pain in his right wrist. Radiology performed demonstrated lunate sclerosis. Diagnostic arthroscopy revealed healthy articular surfaces. Single osteotomy capitate shortening was performed with an oscillating saw and fixed with a single cannulated compression screw. A shortening of 1.5mm was obtained with this technique. Results At 1- to 2-year follow-up, all three patients had considerable pain relief but did not have a complete resolution of pain. There was a significant improvement in function and grip strength. There have been no cases with infection, nonunion, avascular necrosis or a need for a salvage procedure. Conclusion The simplified technique of capitate shortening is easy to perform, less traumatic to the capitate vascularity, and leads to good short-term functional results.

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Osteotomies, Core Decompression, and Denervation for the Treatment of Kienböck Disease

Tadisina¹,

Pet²

2022

Hand Clinics

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Early results of partial capitate shortening osteotomy in management of Kienböck disease

Cited by 7 publications

References 17 publications

Treatment of Stages IIIA and IIIB in Kienbock's Disease: A Systematic Review

Treatment of Stages IIIA and IIIB in Kienbock's Disease: A Systematic Review

Single-Cut Single-Screw Capitate-Shortening Osteotomy for Kienbock's Disease

Osteotomies, Core Decompression, and Denervation for the Treatment of Kienböck Disease

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