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Mid-term clinical outcome of radial shortening for kienbock disease.

Ebrahimzadeh MH, Moradi A, Vahedi E, Kachooei AR - J Res Med Sci (2015)

Bottom Line: The VAS pain score, the mean arc of wrist flexion and extension, and grip strength improved significantly preoperatively compared to after recovery from surgery.The mean DASH and Mayo scores improved significantly postoperatively compare with preoperation.Comparing preoperative positive, neuter, and negative ulnar variance, there was no significant difference in terms of VAS, DASH, and Mayo scores as well as ROM and grip strength.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

ABSTRACT

Background: To evaluate the intermediate-term outcomes of radius shortening as a treatment for Kienbock's disease.

Materials and methods: In a historical cohort, 16 skeletally mature patients (9 men and 7 women) with Kienbock disease, who were treated with radial shortening osteotomy between 2002 and 2012, were reviewed in our study. The mean age of our patients was 30 (range 18-43) years old. According to Litchman staging, there were 7 wrists at stage II and 9 wrists at stage III (6 at stage IIIA and 3 at stage IIIB). The data of grip strength, pain (visual analog scale (VAS) score), wrist range of motion (ROM), ulnar variance (according to Palmer method), and the Lichtman stage were gathered before and after surgery. We evaluated overall wrist function using the Mayo Wrist score and disabilities of the arm shoulder and hand (DASH) score before surgery and at the last follow-up.

Results: The average of follow-up was 7 years (range from 5 to 9 years). Preoperative ulnar variance was -1.3 mm (range from 2.5 to 1) preoperatively. The mean postoperative ulnar variance was 1 mm positive (range from 0.5 to 1.5). The VAS pain score, the mean arc of wrist flexion and extension, and grip strength improved significantly preoperatively compared to after recovery from surgery. The Lichtman stage was unchanged in nine patients, one grade worse in six patients, and one grade better in one patient. The mean DASH and Mayo scores improved significantly postoperatively compare with preoperation. Comparing preoperative positive, neuter, and negative ulnar variance, there was no significant difference in terms of VAS, DASH, and Mayo scores as well as ROM and grip strength.

Conclusion: Our study shows that radius shortening surgery improves pain and disability regardless of ulnar variance.

No MeSH data available.


Related in: MedlinePlus

A 31-year-old woman with Kienböck disease. (A and a) Radiograph and associated magnetic resonance image at the time of diagnosis. (B and b) 12 weeks after radial shortening. (C and c) 5 years after operation. Although lunate has been revascularized, lunate collapsed. However, clinical symptoms were minimal
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Figure 1: A 31-year-old woman with Kienböck disease. (A and a) Radiograph and associated magnetic resonance image at the time of diagnosis. (B and b) 12 weeks after radial shortening. (C and c) 5 years after operation. Although lunate has been revascularized, lunate collapsed. However, clinical symptoms were minimal

Mentions: The average of follow-up was 7 years (range from 5 to 9 years). Preoperative ulnar variance was negative for eight patients, positive for 3, and neutral in the other 5. The mean pre and postoperative ulnar variance were −1.3 mm (range from 2.5 to 1) and 1 mm positive (range from 0.5 to 1.5), respectively. The average of preoperative distal radius inclination angle was measured 18.4 ± 4.1. Comparing pre and postoperative, the Lichtman stage was unchanged in nine patients, one grade worse in six patients, and one grade better in one patient [Figure 1].


Mid-term clinical outcome of radial shortening for kienbock disease.

Ebrahimzadeh MH, Moradi A, Vahedi E, Kachooei AR - J Res Med Sci (2015)

A 31-year-old woman with Kienböck disease. (A and a) Radiograph and associated magnetic resonance image at the time of diagnosis. (B and b) 12 weeks after radial shortening. (C and c) 5 years after operation. Although lunate has been revascularized, lunate collapsed. However, clinical symptoms were minimal
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400708&req=5

Figure 1: A 31-year-old woman with Kienböck disease. (A and a) Radiograph and associated magnetic resonance image at the time of diagnosis. (B and b) 12 weeks after radial shortening. (C and c) 5 years after operation. Although lunate has been revascularized, lunate collapsed. However, clinical symptoms were minimal
Mentions: The average of follow-up was 7 years (range from 5 to 9 years). Preoperative ulnar variance was negative for eight patients, positive for 3, and neutral in the other 5. The mean pre and postoperative ulnar variance were −1.3 mm (range from 2.5 to 1) and 1 mm positive (range from 0.5 to 1.5), respectively. The average of preoperative distal radius inclination angle was measured 18.4 ± 4.1. Comparing pre and postoperative, the Lichtman stage was unchanged in nine patients, one grade worse in six patients, and one grade better in one patient [Figure 1].

Bottom Line: The VAS pain score, the mean arc of wrist flexion and extension, and grip strength improved significantly preoperatively compared to after recovery from surgery.The mean DASH and Mayo scores improved significantly postoperatively compare with preoperation.Comparing preoperative positive, neuter, and negative ulnar variance, there was no significant difference in terms of VAS, DASH, and Mayo scores as well as ROM and grip strength.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

ABSTRACT

Background: To evaluate the intermediate-term outcomes of radius shortening as a treatment for Kienbock's disease.

Materials and methods: In a historical cohort, 16 skeletally mature patients (9 men and 7 women) with Kienbock disease, who were treated with radial shortening osteotomy between 2002 and 2012, were reviewed in our study. The mean age of our patients was 30 (range 18-43) years old. According to Litchman staging, there were 7 wrists at stage II and 9 wrists at stage III (6 at stage IIIA and 3 at stage IIIB). The data of grip strength, pain (visual analog scale (VAS) score), wrist range of motion (ROM), ulnar variance (according to Palmer method), and the Lichtman stage were gathered before and after surgery. We evaluated overall wrist function using the Mayo Wrist score and disabilities of the arm shoulder and hand (DASH) score before surgery and at the last follow-up.

Results: The average of follow-up was 7 years (range from 5 to 9 years). Preoperative ulnar variance was -1.3 mm (range from 2.5 to 1) preoperatively. The mean postoperative ulnar variance was 1 mm positive (range from 0.5 to 1.5). The VAS pain score, the mean arc of wrist flexion and extension, and grip strength improved significantly preoperatively compared to after recovery from surgery. The Lichtman stage was unchanged in nine patients, one grade worse in six patients, and one grade better in one patient. The mean DASH and Mayo scores improved significantly postoperatively compare with preoperation. Comparing preoperative positive, neuter, and negative ulnar variance, there was no significant difference in terms of VAS, DASH, and Mayo scores as well as ROM and grip strength.

Conclusion: Our study shows that radius shortening surgery improves pain and disability regardless of ulnar variance.

No MeSH data available.


Related in: MedlinePlus