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Radial shortening for the treatment of Kienböck's disease

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Summary

Twelve patients with Kienböck's disease were treated by radial shortening. Eight patients were in stage II and four in stage III. After an average of 5 years, relief of pain was satisfactory in 10 patients; 8 were in stage II before operation and 2 in stage III. Two patients were dissatisfied because they had persistent pain; both were in stage III before surgery. The range of motion improved moderately. Nonunion at the site of radial osteotomy did not occur. Radiographs at follow up showed consolidation and healing of the lunate in 2 patients, nonprogression of the disease in 9 and increase of the carpal collapse in 1. The procedure helps to prevent further collapse of the lunate especially in stage II and in some patients in stage III.

Résumé

Douze patients atteints de maladie de Kienböck ont été traités par ostéotomie radiale de raccourcissement. Huit d'entre eux étaient au stade II et quatre au stade III. Avec un recul de 5 ans, les douleurs étaient soulagées de façon satisfaisante dans 10 cas, 8 de stade II et 2 de stade III. Deux malades présentaient des douleurs persistantes (tous deux au stade III avant l'opération). La mobilité du poignet était habituellement légérement améliorée. Il n'y a pas eu de pseudarthrose de l'ostéotomie radiale. Les radiographies ont montré une consolidation et une récupération de la trophicité du semi-lunaire dans 2 cas, un arrêt de la progression de la maladie chez 9 autres et une augmentation du pincement carpien dans un cas. En conclusion, cette opération permet de prévenir l'écrasement du semi-lunaire, notamment au stade II et chez quelques malades du stade III.

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Correspondence to S. Amillo.

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Amillo, S., Martinez-Peric, R. & Barrios, R.H. Radial shortening for the treatment of Kienböck's disease. International Orthopaedics 17, 23–26 (1993). https://doi.org/10.1007/BF00195218

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Keywords

  • Public Health
  • Avant
  • Persistent Pain
  • Carpal Collapse
  • Radial Osteotomy