[Osteosynthesis in double elastic nailing of radial shortening osteotomy in Kienböck disease. Apropos of 4 cases].
OBJECTIVE
The author expose a new technique for radial shortening on patients suffering from Kienböck's disease.


METHODS
Between 1985 and 1989 three men and one woman with a mean age of 34 1/2 years (31 to 40) have been operated. The mean follow-up was 7 years (6 to 10). One of the patient was ranked on stage I, two others on stage II and the last one on stage III according to Decoulx's classification. Shortening of the radius was performed and stabilized by double elastic spring-pinning. Two elastic k-wires (18/10) were inserted into the radius medullary canal through the radial styloid process and the postero-medial border of the distal radius. No cast immobilization has been used.


RESULTS
Pain quickly disappeared. All osteotomies healed spontaneously; three within 3 months and the fourth one after more than one year. However, during this period, this man has been able to perform easily and painless heavy manual works.


CONCLUSIONS
Stabilization of the osteotomies was very good and these four patients were able to quickly recover their normal activities. Thanks to this technique the risk of non union seems very limited because osteotomy has been performed in metaphyseal area and contraction of forearm's muscle induces a compression effect on the osteotomy. These findings should be confirmed since our experience is still very limited.


CONCLUSIONS
Double elastic spring-pinning is a simple and efficient technique for radial shortening osteotomy stabilization. It allows to avoid plaster immobilization and also to recover quickly good hand function.
Desmanet
E
E
Service de Chirurgie Orthopédique et Traumatologique, Hôpital de Jolimont, La Louvière, Belgique.
D000328:Adult; D001858:Bone Nails; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D006801:Humans; D008297:Male; D010007:Osteochondritis / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011884:Radius; D016059:Range of Motion, Articular
L'ostéosynthèse par double embrochage souple des ostéotomies de raccourcissement du radius pour maladie de Kienböck. A propos de 4 cas.