Radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease

J Hand Surg Eur Vol. 2017 Mar;42(3):253-259. doi: 10.1177/1753193416676723. Epub 2016 Nov 12.

Abstract

We carried out a retrospective study to analyse the long-term outcome of 36 patients after radial shortening osteotomy for treatment of Lichtman Stage IIIA Kienböck disease at a mean follow-up of 12.1 years (range 5.4-17.5). At review, seven wrists had progressed to Stage IIIB, eight wrists to Stage IV and 21 remained in Stage IIIA. Motion and grip strength were significantly improved. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score at review was 12 points (range 0-52), and patient satisfaction was high. Apart from plate removals in 14 patients and one wrist denervation, no subsequent surgical procedures were done. Radial shortening yields good long-term clinical results, but does not prevent radiographic progression of disease in some patients.

Level of evidence: Therapeutic IV.

Keywords: Kienböck; Lichtman Stage IIIA; radial shortening osteotomy; wrist.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteonecrosis / diagnostic imaging
  • Osteonecrosis / surgery*
  • Osteotomy*
  • Radius / surgery*
  • Range of Motion, Articular
  • Retrospective Studies
  • Treatment Outcome
  • Wrist Joint*
  • Young Adult