Radial osteotomy for Kienböck's disease with displaced fracture of the lunate.
OBJECTIVE
Advanced Kienböck's disease often involves displaced fractures of the lunate; however, whether such fractures affect surgical outcomes remains unclear. The purpose of this study was to evaluate the results of radial osteotomy for Kienböck's disease with displaced fractures of the lunate and whether these fractures would achieve union.


METHODS
We reviewed patients who had radial osteotomy for Kienböck's disease between 1975 and 2004. We included only displaced fractures of the lunate that were apparent on lateral radiography, and 31 patients (24 men, 7 women; mean age, 35 y) were then included in this study. Postoperative state of the lunate and clinical results were compared between cases of union and nonunion.


RESULTS
Preoperatively, mean flexion/extension arc was 76 degrees , and mean grip strength was 22 kg. Postoperatively, mean flexion/extension arc was 84 degrees , and mean grip strength was 30 kg. Radiography revealed fracture healing in 16 wrists. No significant differences between union and nonunion were noted in any assessed clinical items.


CONCLUSIONS
This study showed approximately 50% union after radial osteotomy. Fracture union did not affect clinical results. Clinical results were good considering the advanced stage of Kienböck's disease. Even with displaced fractures of the lunate, radial osteotomy yields results comparable with other treatments for same-stage patients and thus represents a reasonable approach.
Tatebe
Masahiro
M
Department of Hand Surgery, Nagoya University School of Medicine, Showaku, Nagoya, Japan. tatebe@med.nagoya-u.ac.jp
Horii
Emiko
E
Majima
Masataka
M
Koh
Shukuki
S
Nakamura
Ryogo
R
Hirata
Hitoshi
H
D000328:Adult; D005260:Female; D017102:Fracture Healing; D050723:Fractures, Bone / Q000209:etiology / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D012667:Lunate Bone / Q000293:injuries / Q000601:surgery*; D008297:Male; D010020:Osteonecrosis / Q000150:complications / Q000601:surgery*; D010027:Osteotomy; D010147:Pain Measurement; D011884:Radius / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014955:Wrist Joint / Q000601:surgery