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Ulnar variance in Kienböck's disease.

S S Kristensen, E Thomassen, F Christensen

Journal of Hand Surgery (Edinburgh, Scotland)

|June 1, 1986

Summary

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This study found that while "ulnar minus variance" appears common in Kienböck's disease, it may not be a cause. Bone formation can skew measurements, suggesting no direct link between ulnar variance and the disease

Area of Science:

Orthopedics
Radiology
Hand Surgery

Background:

Kienböck's disease affects the lunate bone in the wrist.
The role of ulnar variance, particularly "ulnar minus variant," in Kienböck's disease etiology is debated.

Purpose of the Study:

To investigate the association between ulnar variance and Kienböck's disease.
To determine if "ulnar minus variant" is a causative factor in Kienböck's disease.

Main Methods:

Re-examination of 47 wrists with Kienböck's disease after a mean of 20.5 years.
Standard X-ray projection and a reliable method for measuring ulnar variance by three independent observers.
Comparison of ulnar variance in affected wrists with normal wrists and analysis of changes over time.

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Main Results:

"Ulnar minus variant" was initially overrepresented in Kienböck's disease patients.
Subchondral bone formation in the distal radius was observed in 8 wrists, potentially altering ulnar variance measurements.
Excluding these cases, no statistical difference in mean ulnar variance was found between Kienböck's disease patients and normal wrists.

Conclusions:

The observed "ulnar minus variant" in Kienböck's disease may be an artifact of bone formation, not a primary cause.
Current evidence suggests "ulnar minus variant" is unlikely to be a significant factor in the pathogenesis of Kienböck's disease.