[Use of radial shortening for Kienbock disease].

Tunis Med

Service de chiruirgie orthopédique et traumatologique de I'hôpital Aziza Othmana de Tunis, Tunis. Tunisie.

Published: August 2005

Kienbock disease is caused by aseptic necrosis of the lunate. The aim of this work is to evaluate the results of the radial shortening procedure for the treatment of stages II. Illa IIb of the disease. We retrospectively reviewed 20 cases of Kienbock disease. This series is composed of 9 men and 11 women. The average age was 32 years. According to Litchman's classification; 17 patients were operate on in stage III (14 IIIa; 311Ib) and 3 patients were operate on in stage III. Average of shortening was: 4 mm. the mean Follow -up was 05 years. Functional results were evaluated according to Michon score. The results were good in 18 cases and poor in 02 cases. Radiologic results were good: Ameliorations were obtained in 3 patients with stage II; 16 stabilizations in 17 patients with stage IIIa and 1 deterioration in 4 patients with stage IIIb. Radial shortening is effective in the treatment of 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 aspect of the lunate changes is not likelly to undergo much chance, if any. Osteotomy was effective even in patients who had zero or positive ulnar variance; and an inclination angle of the distal part of the radius.

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