The Journal of Bone and Joint Surgery, Vol 64, Issue 2 170-178, Copyright © 1982 by Journal of Bone and Joint Surgery, Inc
Ulnar lengthening in the treatment of Kienbock's disease
RB Armistead, RL Linscheid, JH Dobyns and RD Beckenbaugh
Twenty patients with Kienbock's disease were treated with a modification of
the Persson ulnar-lengthening procedure to remove compressive stress from
the damaged lunate. After an average follow-up of thirty-seven months,
relief of pain was satisfactory in eighteen patients who had returned to
work (nine of whom had strenuous occupations), and two patients were
dissatisfied because they had persistent pain and were not able to return
to their previous occupations. Non-union at the site of the ulnar osteotomy
occurred in three patients who were treated early in the series and was the
result of inadequate internal fixation or insufficient duration of
protective splinting. All three of the patients had satisfactory results
after replating and bone-grafting. The procedure appears to help to
maintain carpal height, prevent further collapse of the lunate, encourage
consolidation of the fragmented lunate, and increase grip strength. Except
for ulnar deviation, which the procedure may further diminish, the
postoperative motions of the wrist were moderately improved.
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