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Hand Microsurg. 2012; 1(3): 99-102


Results of treatment stage 2 and stage 3 Kienböck’s disease by distal radial shortening osteotomy

Ali Güleç, Harun Kütahya, Hasan Metineren, Burkay Kutluhan Kaçýra, Onur Bilge, Serdar Toker.

Abstract
Objectives: We aimed to investigate the mid- and long-term results of joint leveling treatment by distal radius shortening osteotomy and distal volar plate fixation in Kienböck’s disease.
Methods: The study was planned for 22 of 29 patients who were diagnosed as Kienböck’s disease and had distal radius shortening osteotomy. Fifteen of 22 patients who were followed-up regularly were included to the study. Five patients were in stage 2, 3 patients were in stage 3A and 7 patients were in stage 3B. In the last controls, both hands’ grip strength, flexion-extension degrees, radial-ulnar deviation degrees, preoperative and postoperative carpal height ratio and preoperative and postoperative ulnar variances were recorded. Pain evaluation was performed by Visual Analogue Scale (VAS).
Results: Clinical results were evaluated according to Modified Nakamura Scoring System. Thirteen patients (87%) had excellent results while 2 (13%) of them had good results. In radiological evaluation it was seen that ulnar variance decreased to mean -0.14 mm which was mean -2,.5 mm before the operations. Carpal height ratio was found to be mean 1.29.
Conclusion: Joint leveling treatment by distal radius shortening osteotomy and volar plate fixation technique in Kienböck’s disease from stage 2 to stage 3B, is a reliable, and clinically successful treatment modality.

Key words: Kienböck disease, radial shortening ostetomy, volar plating



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