title: Radial osteotomy for Kienböck disease.
abstract: Of various surgical treatments, radial shortening for patients with negative ulnar variance and radial wedge osteotomy (radial closing osteotomy) for patients with 0 or positive ulnar variance are widely accepted for the treatment of Kienböck disease. Long-term follow-up studies have shown more than 10 years lasting satisfactory pain relief, as well as an increase in wrist range of motion and grip strength. As representative surgical procedures, the techniques of radial shortening by transverse osteotomy, using a locking compression plate for internal fixation, and radial wedge osteotomy by step-cut osteotomy, using a small dynamic compression plate or locking compression plate, are described. One important point of radial wedge osteotomy is that resection of simple wedge bone yields a decrease in ulnar variance; therefore, we recommend trapezoidal bone resection with ulnar height of 1 mm for transverse osteotomy at the metaphysis and ulnar height of 2 mm for step-cut osteotomy at the distal fourth of the radius.
authors.affiliation: Nagoya Hand Center, Department of Orthopedic Surgery, Chunichi Hospital, Nagoya, Japan. h_geka@chunichi-hp.jp
authors.forename: Ryogo
authors.initials: R
authors.lastname: Nakamura
authors.forename: Etsuhiro
authors.initials: E
authors.lastname: Nakao
authors.forename: Takanobu
authors.initials: T
authors.lastname: Nishizuka
authors.forename: Sayako
authors.initials: S
authors.lastname: Takahashi
authors.forename: Shukuki
authors.initials: S
authors.lastname: Koh
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D002348:Carpal Bones / Q000000981:diagnostic imaging; D019299:Decompression, Surgical; D018737:Hand Strength; D006801:Humans; D012667:Lunate Bone / Q000601:surgery; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011182:Postoperative Care; D011859:Radiography; D011884:Radius / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology