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Radial wedge osteotomy for Kienböck disease
R Nakamura1, S Tsuge, K Watanabe
1Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan.
The Journal of Bone and Joint Surgery. American Volume
|October 1, 1991
Summary
Radial wedge osteotomy effectively treated Kienböck disease, relieving pain and improving wrist function. This surgical approach demonstrated positive outcomes even with varying ulnar variance.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Wrist Arthroscopy
Background:
- Kienböck disease involves avascular necrosis of the lunate, leading to wrist pain and dysfunction.
- Limited treatment options exist for advanced Kienböck disease, often requiring salvage procedures.
Purpose of the Study:
- To evaluate the efficacy of radial wedge osteotomy in treating Kienböck disease.
- To assess pain relief, range of motion, grip strength, and overall patient satisfaction.
Main Methods:
- Twenty-seven patients with Kienböck disease underwent a radial wedge osteotomy.
- The procedure involved reducing the inclination angle of the distal radius.
- Follow-up ranged from two to five years.
Main Results:
- All patients reported pain relief or only mild pain during strenuous activity.
- Wrist flexion-extension improved by over 10 degrees in approximately 50% of patients.
- Grip strength increased by 5 kg or more in most patients.
- 88% of patients had satisfactory outcomes based on Lichtman criteria.
Conclusions:
- Radial wedge osteotomy is an effective surgical treatment for Kienböck disease.
- The procedure provides significant pain relief and functional improvement.
- It is a viable option regardless of ulnar variance status.