Lateral closing wedge osteotomy for treatment of Kienböck's disease. A clinical and biomechanical study of the optimum correcting angle.
A retrospective clinical analysis of 20 patients who underwent a lateral closing wedge osteotomy of the radius as an adjuvant procedure to a radial recession in the treatment of Kienböck's disease is reported. The functional outcome is compared to the results of a simplified two-dimensional articulating force analysis (Rigid Body Spring Model) based on radiographs of the wrist of the same patients taken before and after surgery. At an average follow-up of 39 months, wrist function was excellent in 4 patients, good in 9, moderate in 6, and poor in one patient. A significant positive correlation between functional improvement and percent reduction of the calculated peak pressure at the radiolunate interval was found. This was maximal in patients with wedge osteotomies between 5 and 10 degrees.
Garcia-Elias
M
M
Orthopedic Biomechanics Laboratory, Mayo Clinic/Mayo Foundation, Rochester, Minnesota 55905, USA.
An
K N
KN
Cooney
W P
WP
Linscheid
R L
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010007:Osteochondritis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies