Radial shortening for the treatment of Kienb�ck's disease

Amillo, S.; Martínez-Peric, R; Barrios, R. H.

doi:10.1007/bf00195218

Cited by 15 publications

(5 citation statements)

References 13 publications

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“…Radial shortening osteotomy for patients with negative ulnar variance significantly unloads the lunate (Horii et al, 1990; Makabe et al, 2011) and has proven an appropriate treatment solution for Kienböck’s disease. Clinical and radiological early and mid-term results of RSO are well-documented (Amillo et al, 1993; Buck-Gramcko et al, 1990; Calfee et al, 2010; Das Gupta et al, 2003; Marti et al, 1981; Nakamura et al, 1995; Weiss, 1993), but only four studies report the long-term outcome after RSO (Koh et al, 2003; Raven et al, 2007; Watanabe et al, 2008; Zenzai et al, 2005) (Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of Kienböck’s disease is still controversial, but radial shortening osteotomy (RSO) for patients with negative ulnar variance is widely accepted (Amillo et al, 1993; Calfee, 2010; Das Gupta et al, 2003; Marti et al, 1981; Nakamura et al, 1990; 1995; Razemon, 1984; Takahara et al, 2009; Wada et al, 2002; Weiss, 1993). Four studies have shown that the effect may last for two decades (Koh et al, 2003; Raven et al, 2007; Watanabe et al, 2008; Zenzai et al, 2005), but only two studies have used patient-based assessment (Raven et al, 2007; Watanabe et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcome (20 to 33 years) of radial shortening osteotomy for Kienböck’s lunatomalacia

Viljakka

Tallroth

Vastamäki

2013

J Hand Surg Eur Vol

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Radial shortening osteotomy (RSO) as treatment for Kienböck's disease usually improves patient symptoms for several years. Four small series have also shown that the effect may last for decades, but only two studies have used a patient-based assessment. We examined 16 patients, with a mean age at operation of 32 years, evaluating clinical and radiological results at a mean 25 (range 20 to 33) years after surgery. Three patients had progressive lunate collapse, of whom one patient needed a silicone implant arthroplasty 2 years after RSO and one patient a wrist fusion 16 years after RSO. The time between onset of symptoms and osteotomy in the remaining 14 patients averaged 20 months. The mean VAS for pain was 0.9 at rest, 0.9 with unloaded motion, 1.7 with slight, and 3.0 with heavy exertion. Two patients had marked wrist pain. Compared with the contralateral wrist the mean range of motion was 88%, grip strength was 95%, and key pinch 107%. The Disabilities of the Arm, Shoulder, and Hand score averaged 6.1, and the Mayo wrist score, 79.3. The Lichtman stage remained unchanged in 56% of patients. The inner structure of the lunate improved in all patients, and its shape remained unchanged in half of the cases. Radial shortening osteotomy provides decade-long improvement in 75% of patients and seems to be a reasonable treatment for symptomatic Kienböck's disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term outcome (20 to 33 years) of radial shortening osteotomy for Kienböck’s lunatomalacia

Viljakka

Tallroth

Vastamäki

2013

J Hand Surg Eur Vol

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“…If ulnar minus variance was not a causal factor for Kienböck's disease, then operative realignment of the radius and ulna would be unwarranted. Many authors reported satisfactory long-term results following joint levelling procedures [1,14,19]. However, it is still unclear whether joint levelling can change the natural course of Kienböck's disease.…”

Section: Discussionmentioning

confidence: 99%

“…It was concluded that compression of the lunate by this anatomic "ulnar minus variant" predisposed to avascular necrosis of the lunate bone. Consequently, joint levelling procedures, designed to correct ulnar minus variant and to unload the lunate, have been reported to achieved good clinical results in the treatment of patients with Kienböck's disease [1].…”

Section: Introductionmentioning

confidence: 99%

Ulnar variance and the role of joint levelling procedure for Kienb�ck's disease

Muramatsu

Ihara

Kawai

et al. 2003

International Orthopaedics

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Forty patients with Kienböck's disease were reviewed to determine the relationship between ulnar variance and the development of Kienböck's disease in a Japanese cohort. The joint levelling procedures designed to correct ulnar variance were evaluated in 11 patients after a mean of 9.7 years following surgery. The mean ulnar variance was 0.50+/-1.67 in patients with Kienböck's disease and 0.56+/-1.76 in a control group. The onset of wrist symptoms in a younger age group was noticed after sports injuries, whereas older patients had no distinct history of trauma. Joint levelling procedures produced good clinical results, but carpal height ratio, Stahl's index and radioscaphoid angle were not improved, as evidenced radiographically. Our study suggests that in a Japanese cohort ulnar minus variance is not an important factor in the aetiology of Kienböck's disease. Although joint levelling procedures improved the clinical results, they did not reverse lunate collapse or carpal alignment.

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“…6) oder Ulnaverlänge-rung erreicht werden. In vielen Studien konnte hierdurch bei einem Großteil der Patienten eine Reduktion der Schmerzen erzielt werden [29,30,33,64,65,66,67,68,69]. In großen Studien wird auch über eine Verbesserung der Handgelenksbeweglichkeit nach solchen Operationen berichtet.…”

Section: Niveauangleichende Operationenunclassified

Morbus Kienböck

Horch

Unglaub

Dragu

et al. 2008

Chirurg

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Kienböck's disease (carpal lunate necrosis or lunatomalacia) is the most common aseptic osteonecrosis of the upper extremity. Other bone necroses in the hand occur less frequently. The name indicates a disease with unclear etiology which eventually always leads to necrosis of the lunate bone. It usually affects the dominant hands of males between 20 and 40 years of age. Treatment methods extend from immobilization to revascularization surgery on the affected bone. There is still no gold standard for the treatment of Kienböck's disease.

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Radial shortening for the treatment of Kienb�ck's disease

Cited by 15 publications

References 13 publications

Long-term outcome (20 to 33 years) of radial shortening osteotomy for Kienböck’s lunatomalacia

Long-term outcome (20 to 33 years) of radial shortening osteotomy for Kienböck’s lunatomalacia

Ulnar variance and the role of joint levelling procedure for Kienb�ck's disease

Morbus Kienböck

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