Download PDF
J Wrist Surg 2021; 10(04): 296-302
DOI: 10.1055/s-0041-1723976
Scientific Article

Comparison of Biomechanical Results about the Effect of Three Surgery Methods in Decompression of Lunate Bone

Hamid Namazi
1   Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Ebrahim Ghaedi
1   Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Mohammad T. Karimi 
2   Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Objective Kienbock's disease is an unusual disorder caused by osteonecrosis and the collapse of lunate bone which leads to pain and a chronic decrease in wrist function. The treatments in this disease aim to relieve pain and maintain wrist function and movement. Various surgical procedures have been recommended for the subjects with Kienbock's disease; however, the main question posed here is which of the selected procedures are more successful in relief of the pressure applied on lunate.

Methods and Materials Computed tomography (CT) scan images of a normal subject were used to create a three-dimensional model of the wrist joint. The effects of several surgical procedures, including radial shortening, capitate shortening, and a combination of both radial and capitate shortening, on the joint contact force of the wrist bones were investigated.

Results The pressure applied to the lunate bone in articulation with radius, scaphoid, capitate, hamate, and triquetrum varied between 19.7 and 45.4 MPa. The Von Mises stress, maximum principal stress, and minimum principal stress decreased in the model with a combination of radius and capitate shortening.

Conclusion It can be concluded from the results of this study that the combinations of radius and capitate shortening seem to be an effective procedure to decrease joint pressure, if the combined surgery could not be done, shortening of radius or capitate would be recommended.

Level of Evidence This is a Level III study.

Keywords

Kienbock's disease - radial shortening - capitate shortening - finite element analysis


Publication History

Received: 28 April 2020

Accepted: 29 December 2020

Article published online:
15 February 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Leonard Jr J. Anatomy of Gray. New York, NY: Samuel French, Inc.; 2006: 87
    Search in Google Scholar
  • 2 Gelberman RH, Szabo RM. Kienböck's disease. Orthop Clin North Am 1984; 15 (02) 355-367
    CrossrefPubMedSearch in Google Scholar
  • 3 Innes L, Strauch RJ. Systematic review of the treatment of Kienböck's disease in its early and late stages. J Hand Surg Am 2010; 35 (05) 713-717 , 717.e1–717.e4
    CrossrefPubMedSearch in Google Scholar
  • 4 Martin GR, Squire D. Long-term outcomes for Kienböck's disease. Hand (N Y) 2013; 8 (01) 23-26
    CrossrefPubMedSearch in Google Scholar
  • 5 Stahl S, Santos Stahl A, Rahmanian-Schwarz A. et al. An international opinion research survey of the etiology, diagnosis, therapy and outcome of Kienböck's disease (KD). Chir Main 2012; 31 (03) 128-137
    CrossrefPubMedSearch in Google Scholar
  • 6 Schiltenwolf M, Martini A, Eversheim S, Mau H. Die Bedeutung des intraossären Druckes für Pathogenesis von Kienbock. Handchir Mikrochir Plast Chir 1996; 28: 215-219
    PubMedSearch in Google Scholar
  • 7 Hultén O. ÜBER ANATOMISCHE VARIATIONEN DER HANDGELENKKNOCHEN: Ein Beitrag zur Kenntnis der Genese zwei verschiedener Mondbeinveränderungen. Acta Radiologica 1928; os-9 (02) 155-168
    PubMedSearch in Google Scholar
  • 8 Ledoux P, Lamblin D, Wuilbaut A, Schuind F. A finite-element analysis of Kienbock's disease. J Hand Surg Eur Vol 2008; 33 (03) 286-291
    CrossrefPubMedSearch in Google Scholar
  • 9 De Smet L. Ulnar variance: facts and fiction review article. Acta Orthop Belg 1994; 60 (01) 1-9
    PubMedSearch in Google Scholar
  • 10 D'Hoore K, De Smet L, Verellen K, Vral J, Fabry G. Negative ulnar variance is not a risk factor for Kienböck's disease. J Hand Surg Am 1994; 19 (02) 229-231
    CrossrefPubMedSearch in Google Scholar
  • 11 Nathan PA, Meadows KD. Ulna-minus variance and Kienböck's disease. J Hand Surg Am 1987; 12 (5, pt 1): 777-778
    CrossrefPubMedSearch in Google Scholar
  • 12 Koh S, Nakamura R, Horii E, Nakao E, Inagaki H, Yajima H. Surgical outcome of radial osteotomy for Kienböck's disease-minimum 10 years of follow-up. J Hand Surg Am 2003; 28 (06) 910-916
    CrossrefPubMedSearch in Google Scholar
  • 13 Schmitt R, Fellner F, Obletter N, Fiedler E, Bautz W. [Diagnosis and staging of lunate necrosis. A current review]. Europe PMC 1998; 30 (03) 142-150
    PubMedSearch in Google Scholar
  • 14 Matsui Y, Funakoshi T, Motomiya M, Urita A, Minami M, Iwasaki N. Radial shortening osteotomy for Kienböck disease: minimum 10-year follow-up. J Hand Surg Am 2014; 39 (04) 679-685
    CrossrefPubMedSearch in Google Scholar
  • 15 Trumble T, Glisson RR, Seaber AV, Urbaniak JR. A biomechanical comparison of the methods for treating Kienböck's disease. J Hand Surg Am 1986; 11 (01) 88-93
    CrossrefPubMedSearch in Google Scholar
  • 16 Allan CH, Joshi A, Lichtman DM. Kienbock's disease: diagnosis and treatment. J Am Acad Orthop Surg 2001; 9 (02) 128-136
    CrossrefPubMedSearch in Google Scholar
  • 17 Park IJ, Kim HM, Lee JY. et al. Treatment of Kienböck's disease using a fourth extensor compartmental artery as a vascularized pedicle bone graft. J Plast Reconstr Aesthet Surg 2016; 69 (10) 1403-1410
    CrossrefPubMedSearch in Google Scholar
  • 18 Stahl S, Hentschel PJH, Santos Stahl A, Meisner C, Schaller H-E, Manoli T. Comparison of clinical and radiologic treatment outcomes of Kienböck's disease. J Orthop Surg Res 2015; 10: 133
    CrossrefPubMedSearch in Google Scholar
  • 19 Liang G. Effect of muscular forces on the stress distribution in the proximal femur [dissertation]. Singapore: National University of Singapore; 2012
    Search in Google Scholar
  • 20 Bettinger PC, Smutz WP, Linscheid RL, Cooney III WP, An KN. Material properties of the trapezial and trapeziometacarpal ligaments. J Hand Surg Am 2000; 25 (06) 1085-1095
    CrossrefPubMedSearch in Google Scholar
  • 21 Savelberg HH, Kooloos JG, Huiskes R, Kauer JM. Stiffness of the ligaments of the human wrist joint. J Biomech 1992; 25 (04) 369-376
    CrossrefPubMedSearch in Google Scholar
  • 22 Bajuri MN, Abdul Kadir MR, Murali MR, Kamarul T. Biomechanical analysis of the wrist arthroplasty in rheumatoid arthritis: a finite element analysis. Med Biol Eng Comput 2013; 51 (1-2): 175-186
    CrossrefPubMedSearch in Google Scholar
  • 23 Gislason MK, Nash DH, Nicol A. et al. A three-dimensional finite element model of maximal grip loading in the human wrist. Proc Inst Mech Eng H 2009; 223 (07) 849-861
    CrossrefPubMedSearch in Google Scholar
  • 24 Wolfram U, Schwiedrzik J. Post-yield and failure properties of cortical bone. Bonekey Rep 2016; 5: 829-829
    CrossrefPubMedSearch in Google Scholar