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Capitate osteotomy and transposition for type III Kienböck's disease
Jianbing Li1,2, Zhijun Pan1,2, Yunzhen Zhao3
11 Department of Orthopaedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
The Journal of Hand Surgery, European Volume
|June 8, 2018
Summary
Capitate osteotomy and transposition effectively treats stage III Kienböck's disease. This surgical approach demonstrated high patient satisfaction and functional recovery, with minimal complications in a recent study.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Wrist Reconstruction
Background:
- Kienböck's disease is a condition affecting the lunate bone in the wrist.
- Stage III Kienböck's disease involves significant structural changes.
- Current treatment options aim to preserve wrist function and alleviate pain.
Purpose of the Study:
- To evaluate the efficacy of capitate osteotomy and transposition for stage III Kienböck's disease.
- To assess patient outcomes, including pain, function, and grip strength.
- To determine the complication rate associated with this surgical technique.
Main Methods:
- Seventeen patients with stage III Kienböck's disease underwent capitate osteotomy and transposition.
- The procedure was combined with an autologous iliac bone graft.
- Patient outcomes were assessed using visual analogue scale (VAS) for pain and the Wrightington wrist function score.
Main Results:
- A mean follow-up of 68 months showed a low mean VAS score of 0.6.
- The mean Wrightington wrist function score was 8, indicating good functional recovery.
- Grip strength averaged 79% of the unaffected side, with 16 out of 17 patients reporting satisfactory results.
Conclusions:
- Capitate osteotomy and transposition is a simple and reliable surgical option for stage III Kienböck's disease.
- The procedure leads to significant pain reduction and functional improvement.
- The technique has a low complication rate, with nonunion being the only reported issue in this series.
