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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 5, 673-677.
doi: 10.1302/0301-620X.84B5.12589  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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Radial osteotomy for late-stage Kienböck’s disease

WEDGE OSTEOTOMY VERSUS RADIAL SHORTENING

N. Iwasaki, MD, Assistant Professor; A. Minami, MD, Professor; N. Oizumi, MD, Hand Fellow; N. Suenaga, MD, Assistant Professor; and H. Kato, MD, Assistant Professor

Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan.

M. Minami, MD, Consultant Orthopaedic Surgeon

Hokkaido Orthopaedic Memorial Hospital, Hiragishi-7-13, Toyohira-ku, Sapporo 062-0937, Japan.

Correspondence should be sent to Dr N. Iwasaki.

We have reviewed 20 patients stage-IIIB and stage-IV Kienböck’s disease in order to examine the efficacy of two forms of radial osteotomy, namely radial wedge osteotomy and radial shortening. Lateral closing wedge osteotomies and radial shortenings were carried out on 11 and nine patients, respectively. There were no preoperative differences with respect to age, gender, and radiological stage.

After a mean follow-up of 29 months, all patients, in both groups, had either a good or an excellent outcome. After the lateral closing wedge osteotomy, the radioscaphoid angle significantly increased and the Ståhl index significantly decreased. Progression of the degenerative changes at the radioscaphoid joint was found in two patients in this group. By contrast, there were no significant changes in any radiological parameters after radial shortening. Both procedures gave acceptable clinical results in stage-IIIB and stage-IV Kienböck’s disease.




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J Bone Joint Surg Br, February 1, 2008; 90-B(2): 133 - 139.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General