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.
Illarramendi
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AA
Instituto Carlos E. Ottolenghi, Hospital Italiano, Potosí 4215, C.P. 1199, Buenos Aires, Argentina.
Schulz
C
C
De Carli
P
P
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*