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Kienböck's disease in elderly patients.
Yasunori Taniguchi1, Munehito Yoshida, Hiroshi Iwasaki
1Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan.
The Journal of Hand Surgery
|September 26, 2003
Summary
Kienböck's disease in older adults often affects the dominant hand of manual laborers. This study found it more common in women, with low negative ulnar variance, suggesting different causes in the elderly.
Area of Science:
- Orthopedics
- Hand Surgery
- Radiology
Background:
- Kienböck's disease typically affects young to middle-aged men in their dominant hands.
- Previous studies suggest distinct characteristics in elderly populations.
Purpose of the Study:
- To investigate the specific features of Kienböck's disease in patients over 60 years old.
- To compare elderly Kienböck's disease presentation with established demographic and radiographic profiles.
Main Methods:
- Retrospective analysis of 14 elderly patients (15 wrists) with Kienböck's disease.
- Evaluation of patient demographics, occupation, affected side, and dominant hand.
- Radiographic assessment using Lichtman's classification, ulnar variance, and carpal height ratio.
- Clinical outcomes assessed using Dornan criteria.
Main Results:
- The disease occurred in 10 women and 4 men, with onset in the 60s for most.
- It was commonly observed in the dominant hand of manual workers.
- Carpal collapse was evident in all patients, yet clinical results were good or excellent.
- Negative ulnar variance was infrequent (2 wrists).
Conclusions:
- Kienböck's disease in the elderly shares some characteristics with younger patients, such as affecting the dominant hand of manual workers.
- However, it appears more frequently in women and less often associated with negative ulnar variance in this age group.
- These differences suggest potentially distinct etiologic factors in elderly patients with Kienböck's disease.