Closing Radial Wedge Osteotomy for Preiser Disease: Clinical Outcomes

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Radiology

Background:

• Preiser disease, a form of avascular necrosis of the scaphoid bone, can lead to significant wrist pain and dysfunction.
• Treatment options for Preiser disease aim to alleviate pain, preserve wrist function, and prevent further collapse.
• Closing radial wedge osteotomy (CRWO) is a surgical technique that has been explored for managing wrist conditions.

Purpose of the Study:

• To evaluate the clinical outcomes of Preiser disease treated with closing radial wedge osteotomy (CRWO).
• To assess the impact of CRWO on pain, range of motion (ROM), grip strength, and radiographic progression.

Main Methods:

• Seven patients diagnosed with Preiser disease underwent CRWO.
• Preoperative and postoperative assessments included radiography, magnetic resonance imaging (MRI), range of motion, grip strength, and Modified Mayo Wrist Score (MMWS).
• Radiographic staging (Herbert-Lanzetta and Kalainov criteria) and measurement of radiolunate and scapholunate angles were performed.

Main Results:

• Postoperative complications were minimal, with one case of extensor pollicis longus tendon rupture and another of distal radioulnar joint osteoarthritis.
• At final follow-up, 5 wrists were pain-free, and 2 had mild pain.
• Median ROM was 80% of the contralateral wrist in extension and 73% in flexion, with median grip strength at 71% and median MMWS of 75 points.

Conclusions:

• CRWO demonstrated effectiveness in alleviating wrist pain and maintaining or improving ROM and grip strength in patients with Preiser disease.
• Despite radiographic progression in some cases, CRWO represents a potential therapeutic option for managing Preiser disease symptoms.
• The procedure may help preserve wrist function and reduce pain, offering a valuable alternative for selected patients.