The Journal of Bone and Joint Surgery, Vol 73, Issue 3 384-391, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Radial shortening for Kienbock disease
AP Weiss, AJ Weiland, JR Moore and EF Wilgis
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The cases of twenty-nine consecutive patients (thirty wrists) who had
radial shortening for the treatment of stages I through IIIB Kienbock
disease were reviewed to assess the results of this procedure. Thirteen
patients (45 per cent) had a history of trauma, and all thirty wrists had a
negative ulnar variance (average, 2.8 millimeters) on radiographs. All
wrists were re-examined after an average follow-up of 3.8 years (minimum,
two years). At that time, the pain had decreased in 87 per cent of the
wrists. Extension of the wrist had improved an average of 32 per cent;
flexion, 27 per cent; radial deviation, 30 per cent; ulnar deviation, 41
per cent; and grip strength on the affected side, 49 per cent. Analysis of
the radiographs by computer digitization showed no significant changes in
the amount of collapse of the lunate at the latest follow-up. In two
wrists, there were complications at follow-up (excessive shortening of the
radius and non-union of the radial osteotomy). Radial shortening is an
effective treatment for Kienbock disease in wrists that do not have
degenerative changes in adjacent carpal joints. Pain, range of motion, and
strength can be expected to improve, but the radiographic appearance of the
lunate changes little, if any.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
