Jnl Wrist Surg 2019; 08(04): 264-267
DOI: 10.1055/s-0039-1688947
Special Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment of Advanced Kienbock's Disease (Lichtman Stage IIIB with Carpal Collapse) by a Shortening Osteotomy of the Radius: 21 Cases

J. C. Botelheiro
1  Department of Orthopaedics, Hospital dos Lusiadas, Lisbon, Portugal
,
Silvia Silverio
2  Department of Orthopaedics, Hospital de Sant’Ana, Parede, Portugal
,
Ana Luísa Neto
2  Department of Orthopaedics, Hospital de Sant’Ana, Parede, Portugal
› Author Affiliations
Further Information

Publication History

26 February 2019

09 April 2019

Publication Date:
28 May 2019 (eFirst)

Abstract

Purpose To review the results of shortening osteotomies of the radius in our stage IIIB Kienbock's disease patients.

Materials and Methods In the past 30 years, we treated 52 cases of Kienbock's disease by a shortening osteotomy of the radius, of which 21 already had carpal collapse. All patient charts and X-rays were reviewed, but only the cases already with carpal collapse (stage IIIB) are presented here.

Results All patients improved after surgery. Pain, on a scale of 0 to 3, generally 2 or 3 before surgery (median: 2.3), was normally 1 or 0 afterward (median: 0.9); median flexion–extension of the wrist improved from 77 to 99 degrees; and grip strength of the other hand improved from 26 to 76%. The last clinical and radiological review was performed 1 to 23 years after surgery (median: 8 years).

Conclusion Advanced Kienbock’s disease with carpal collapse is not a contraindication for carpal-sparing surgery radial shortening osteotomy.