Predictors of clinical results of radial osteotomies for Kienböck's disease.
The factors affecting the clinical results after radial osteotomies for Kienböck's disease are unknown. In the current study, we reviewed the data of 41 patients treated with radial osteotomies for Kienböck's disease and analyzed which preoperative factors significantly affected the clinical results of these procedures. Lateral closing wedge osteotomies of the radius were done for 22 patients (six patients with Lichtman Stage II disease, three patients with Lichtman Stage IIIA disease, 12 patients with Lichtman Stage IIIB disease, and one patient with Lichtman Stage IV disease) with zero or positive ulnar variance, and radial shortenings were done for 19 patients (four patients with Stage II disease, two patients with Stage IIIA disease, 12 patients with Stage IIIB disease, and one patient with Stage IV disease) with negative ulnar variance. The mean age of the patients at surgery was 36 years and the average followup was 38 months. To statistically assess the prognostic factors, multiple regression analysis focused on the postoperative clinical score as a dependent variable and preoperative patient data as independent variables. In the current analysis, patient age was the preoperative factor most clearly predictive of clinical results after radial osteotomies for Kienböck's disease. We think that the lower effectiveness of radial osteotomies must be considered in doing these procedures for elderly patients.
Iwasaki
Norimasa
N
Department of Orthopedic Surgery, Hokkaido University School of Medicine, Kita-Ku, Sapporo, Japan. niwasaki@med.hokudai.ac.jp
Minami
Akio
A
Oizumi
Naomi
N
Yamane
Shintarou
S
Suenaga
Naoki
N
Kato
Hiroyuki
H
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D012667:Lunate Bone; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods* / Q000592:standards; D010146:Pain / Q000209:etiology; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D011884:Radius / Q000601:surgery*; D016059:Range of Motion, Articular; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014457:Ulna / Q000473:pathology / Q000503:physiopathology