Temporary scaphotrapezoidal joint fixation for adolescent Kienböck's disease.
OBJECTIVE
There are few therapeutic guidelines for adolescent Kienböck's disease. The purpose of our study was to investigate the clinical and radiographic outcomes of temporary scaphotrapezoidal (ST) joint fixation for adolescent Kienböck's disease.


METHODS
This was a retrospective review of 6 adolescent patients with Kienböck's disease treated by temporary ST joint fixation. All patients had pain with rest and activity before surgery. The mean patient age at the time of surgery was 14 years, and final follow-up examination was at a mean of 23 months. Under general anesthesia, 2 or 3 K-wires were inserted from the dorsal trapezoid to the scaphoid. The wires were removed at 3 to 6 months.


RESULTS
Mean postoperative wrist extension and flexion were increased from 46 degrees and 48 degrees to 68 degrees and 77 degrees , respectively. These improvements were statistically significant compared with preoperative wrist extension and flexion. Grip strength significantly increased from 52% to 86% of the unaffected side. None of the 6 patients had postoperative pain either at rest or with activity. On final follow-up wrist x-ray films, none of the patients had sclerotic change or fragmentation of the lunate, although decreased lunate height remained in all patients. Magnetic resonance imaging revealed improvement to nearly normal intensity of the lunate on T1- and T2-weighted images in all patients.


CONCLUSIONS
Both clinical and radiographic outcomes of temporary ST joint fixation for adolescent Kienböck's disease were excellent. We therefore recommend this procedure for the surgical treatment of adolescent Kienböck's disease.


METHODS
Therapeutic IV.
Ando
Yoshiyuki
Y
Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan. ando7122000@yahoo.co.jp
Yasuda
Masataka
M
Kazuki
Kenichi
K
Hidaka
Noriaki
N
Yoshinaka
Yasutaka
Y
D000293:Adolescent; D001864:Bone Wires; D050824:Carpal Joints / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002370:Casts, Surgical; D002648:Child; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010020:Osteonecrosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013165:Splints; D051223:Trapezoid Bone / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014955:Wrist Joint / Q000503:physiopathology