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Total Wrist Fusion in the Management of Kienböck’s Disease

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Kienböck’s Disease

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Abstract

Kienböck’s disease is a painful condition that leads to progressive degeneration of the carpus, loss of grip strength and range of motion (ROM). Chondral loss is thought to start in the radiolunate articulation and progress to the capitolunate joint before globally affecting the wrist. In advanced Kienböck’s disease, where chondral loss and loss of carpal height make only salvage possible, the chosen surgical intervention should be directed by the level of symptoms and the anatomical site of degeneration. Motion-sparing procedures have been recommended with variable improvement in pain, ROM, grip strength, and function reported. When these procedures fail, or if degeneration is too advanced, total wrist arthrodesis (TWA) is the only predictable treatment option. Historically, TWA was a difficult procedure with high morbidity. However, with the advent of modern pre-contoured wrist arthrodesis plates reliable high fusion rates with predictable symptom relief can be achieved. Most patients report a high level of satisfaction following TWA despite the consequent loss of wrist function.

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References

  1. Beckenbaugh RD, Shives TC, Dobyns JH, Linscheid RL. Kienböck’s disease: the natural history of Kienböck’s disease and consideration of lunate fractures. Clin Orthop Relat Res. 1980;149:98–106.

    PubMed  Google Scholar 

  2. Lichtman DM, Mack GR, MacDonald RI, Gunther SF, Wilson JN. Kienböck’s disease: the role of silicon replacement arthroplasty. J Bone Joint Surg Am. 1977;59:899–908.

    CAS  PubMed  Google Scholar 

  3. Swanson AB, De Groot Swanson G, DeHeer DH, Pierce TD, Randall K, Smith JM, et al. Carpal bone titanium implant arthroplasty. 10 years’ experience. Clin Orthop Relat Res. 1997;342:46–58.

    PubMed  Google Scholar 

  4. Viljakka T, Vastamaki M, Solonen K, Tallroth K. Silicone implant arthroplasty in Kienböck’s disease. Acta Orthop Scand. 1987;58:410–4.

    Article  CAS  PubMed  Google Scholar 

  5. Kawai H, Yamamoto K, Yamamoto T, Tada K, Kaga K. Excision of the lunate in Kienböck’s disease. Results after long-term follow-up. J Bone Joint Surg Br. 1988;70:287–92.

    CAS  PubMed  Google Scholar 

  6. Begley BW, Enderberger ED. Proximal row carpectomy in advanced Kienböck’s disease. J Hand Surg Am. 1994;9:1016–8.

    Article  Google Scholar 

  7. Nakamura R, Horii E, Watanabe K, Nakao E, Tsunoda K. Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienböck’s disease. J Hand Surg Br. 1998;23:741–5.

    Article  CAS  PubMed  Google Scholar 

  8. Rhee SK, Kim HM, Bahk WJ, Kim YW. A comparative study of the surgical procedures to treat advanced Kienböck’s disease. J Korean Med Sci. 1996;11:171–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Takase K, Imakiire A. Lunate excision, capitate osteotomy and intercarpal arthrodesis for advanced Kienbock’s disease. Long-term follow up. J Bone Joint Surg Am. 2001;83:177–83.

    Article  PubMed  Google Scholar 

  10. Voche P, Bour C, Merle M. Scapho-trapezio-trapezoid arthrodesis in the treatment of Kienböck’s disease, a study of 16 cases. J Hand Surg Br. 1992;17:5–11.

    Article  CAS  PubMed  Google Scholar 

  11. Tambe AD, Trail IA, Stanley JK. Wrist fusion versus limited carpal fusion in advanced Kienböck’s disease. Int Orthop. 2005;29:355–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Tsou IY, Yegappan M, Ong WS, Goh PO, Tan JL, Chee TS. Cartilage injury and repair: assessment with magnetic resonance imaging. Singapore Med J. 2006;47:80–7.

    CAS  PubMed  Google Scholar 

  13. Watanabe K, Nakamura R, Imaeda T. Arthroscopic assessment of Kienböck’s disease. Arthroscopy. 1995;11:257–62.

    Article  CAS  PubMed  Google Scholar 

  14. Bain GI, Begg M. Arthroscopic assessment of Kienböck’s disease. Tech Hand Up Extrem Surg. 2006;10:8–13.

    Article  PubMed  Google Scholar 

  15. Bain GI, Durrant A. An articular-based approach to Kienböck avascular necrosis of the lunate. Tech Hand Upper Extrem Surg. 2011;15(1):41–7.

    Article  Google Scholar 

  16. Lin HH, Stern PJ. “Salvage” procedures in the treatment of Kienböck’s disease. Proximal row carpectomy and total wrist arthrodesis. Hand Clin. 1993;9:521–6.

    CAS  PubMed  Google Scholar 

  17. Chamay A, Della Santa D. Radiiolunate arthrodesis in rheumatoid arthritis. Ann Hand Surg. 1991;10:197–206.

    CAS  Google Scholar 

  18. Clayton ML. Surgical treatment at the wrist in rheumatoid arthritis: a review of thirty-seven patients. J Bone Joint Surg Am. 1965;47:741–50.

    CAS  PubMed  Google Scholar 

  19. Haddad RJ, Riordan DC. Arthrodesis of the wrist. A surgical technique. J Bone Joint Surg Am. 1967;49:950–4.

    PubMed  Google Scholar 

  20. Carroll RE, Dick HM. Arthrodesis of the wrist for rheumatoid arthritis. J Bone Joint Surg Am. 1971;53:1365–9.

    CAS  PubMed  Google Scholar 

  21. Heim U, Pfeiffer KM. Small fragment set manual. Technique recommended by the ASIF Group. 2nd ed. Berlin: Springer; 1982.

    Book  Google Scholar 

  22. Green DP, Henderson CJ. Modified AO arthrodesis of the wrist (with proximal row carpectomy). J Hand Surg Am. 2013;38:388–91.

    Article  PubMed  Google Scholar 

  23. Brumfield RH, Champoux JA. A biomechanical study of normal functional wrist motion. Clin Orthop. 1984;187:23–5.

    PubMed  Google Scholar 

  24. Rayan GM, Brentlinger A, Purnell D, Gracia-Moral CA. Functional assessment of the bilateral wrist arthrodesis. J Hand Surg Am. 1987;12:1020–4.

    Article  CAS  PubMed  Google Scholar 

  25. Clayton ML, Ferlic DC. Arthrodesis of the arthritic wrist. Clin Orthop Relat Res. 1984;55:1026–34.

    Google Scholar 

  26. Yazaki N, Nakamura R, Nakao E, Iwata Y, Tatebe M, Hattori T. Bilateral Kienböck’s disease. J Hand Surg Br. 2005;30:133–6.

    Article  CAS  PubMed  Google Scholar 

  27. Jebson PJ, Adams BD. Wrist arthrodesis: a review of current techniques. J Am Acad Orthop Surg. 2001;9:53–60.

    Article  CAS  PubMed  Google Scholar 

  28. Nagy L, Buchler U. AO–wrist arthrodesis: with and without arthrodesis of the third carpometacarpal joint. J Hand Surg Am. 2002;27:940–7.

    Article  PubMed  Google Scholar 

  29. Bain GI, McGuire DT. Decision making for partial carpal fusions. J Wrist Surg. 2012;01(02):103–14.

    Article  Google Scholar 

  30. Zachary SV, Stern PJ. Complications following AO/ASIF wrist arthrodesis. J Hand Surg Am. 1995;20:339–44.

    Article  CAS  PubMed  Google Scholar 

  31. Hastings H, Weiss AP, Quenzer D, Wiedeman GP, Hanington KR, Strickland JW. Arthrodesis of the wrist for post-traumatic disorders. J Bone Joint Surg Am. 1996;78:897–902.

    PubMed  Google Scholar 

  32. Hayden RJ, Jebson PJ. Wrist arthrodesis. Hand Clin. 2005;21:631–40.

    Article  PubMed  Google Scholar 

  33. Mackay C, Couzens G, Cutbush K, Duke P, Hodder M, Copely M, Ross M. Wrist arthrodesis with the AO/ASIF wrist fusion plate. In: Proceedings of the 9th Congress of the International Federation of Societies for Surgery of the Hand. Budapest, Hungary, pp. 379–82, 2004.

    Google Scholar 

  34. Sagerman SD, Palmer AK. Wrist arthrodesis using a dynamic compression plate. J Hand Surg Br. 1996;21:437–41.

    Article  CAS  PubMed  Google Scholar 

  35. Weiss AP, Hastings H. Wrist arthrodesis for traumatic conditions: a study of plate and local bone application. J Hand Surg Am. 1995;20:50–6.

    Article  CAS  PubMed  Google Scholar 

  36. Herard J, Cohen G, Bacle G, Laulan J. Results of total wrist arthrodesis for degenerative disease. A review of 30 cases to 5 years. Chir Main. 2008;27:283–4.

    Google Scholar 

  37. Meads BM, Scougall PJ, Hargreaves IC. Wrist arthrodesis using a Synthes wrist fusion plate. J Hand Surg Br. 2003;28:571–4.

    Article  CAS  PubMed  Google Scholar 

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Potential Conflict of Interest

Mark Ross: Fees for consultancy from Integra; fees for lectures and speakers bureaus from Integra, AO; patents pending with Integra; royalties from Integra; and Director of the Brisbane Hand and Upper Limb Research Institute (BHULRI), which receives financial support through charitable donations from Medartis.

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Authors and Affiliations

  1. Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, QLD, Australia

    Mark Ross MBBS, FRACS

  2. Department of Orthopedics, Princess Alexandra Hospital, Brisbane, QLD, Australia

    Mark Ross MBBS, FRACS

  3. School of Medicine, The University of Queensland, Brisbane, QLD, 4072, Australia

    Mark Ross MBBS, FRACS

  4. Department of Orthopedics, Princess Alexandra Hospital, Brisbane, QLD, 4006, Australia

    Steven Marchalleck BSc, BSc (Med Sci), MBBS

Authors
  1. Mark Ross MBBS, FRACS
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  2. Steven Marchalleck BSc, BSc (Med Sci), MBBS
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Correspondence to Mark Ross MBBS, FRACS .

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Editors and Affiliations

  1. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

    David M. Lichtman

  2. Department of Orthopedic Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia

    Gregory Ian Bain

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Ross, M., Marchalleck, S. (2016). Total Wrist Fusion in the Management of Kienböck’s Disease. In: Lichtman, D., Bain, G. (eds) Kienböck’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-34226-9_29

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  • DOI: https://doi.org/10.1007/978-3-319-34226-9_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34224-5

  • Online ISBN: 978-3-319-34226-9

  • eBook Packages: MedicineMedicine (R0)

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