The surgical treatment of Kienböck's disease by radius and ulna metaphyseal core decompression.
We present a new surgical procedure, metaphyseal core decompression, to treat Kienböck's disease. Twenty-two patients were treated between 1976 and 1988 and were retrospectively reviewed. Sixteen were male and 6 female with an average age of 36 years (range, 18-64 years). The surgical technique involved curettage of the distal radius and ulna metaphyseal bone through small cortical windows. The average follow-up period was 10 years (range, 6-16 years). No postoperative complications were noted and no patient underwent additional surgical procedure. Sixteen patients were pain-free; 4 noted occasional pain. Twenty returned to their prior occupation. One patient had moderate pain and altered his occupation. Another had increasing pain and had x-ray evidence of advanced intercarpal arthritis. The average arc of wrist extension and flexion was 77% of the opposite wrist and the average grip strength was 75%. Long-term follow-up monitoring indicates that the metaphyseal core decompression produces results at least as good as other surgical procedures without any postoperative complications.
Instituto Carlos E. Ottolenghi, Hospital Italiano, Potosí 4215, C.P. 1199, Buenos Aires, Argentina.
A A
AA
Illarramendi
C
C
Schulz
P
P
De Carli
D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010007:Osteochondritis / Q000473:pathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014955:Wrist Joint / Q000473:pathology / Q000601:surgery*