title: Long-term clinical and radiological outcomes of radial shortening osteotomy and vascularized bone graft in Kienböck disease.
abstract: OBJECTIVE
  To evaluate the long-term (> 5 y) outcomes of radial shortening osteotomy and vascularized bone graft in Kienböck disease patients.
  
  
  METHODS
  In a retrospective study of 16 patients with early stage Kienböck disease, 9 patients with average follow-up of 6.4 years had radial shortening osteotomy (group 1), and 7 with average follow-up of 6.5 years had pedicled vascularized bone graft based on the distal radius 4 + 5 extensor compartmental artery (group 2). The 2 groups were similar in age, sex, operated side, initial Lichtman stage, and follow-up duration. There were significant differences in ulnar variance between the 2 groups. At the last follow-up, the patients were evaluated for pain, wrist motion, grip strength, functional status, and radiographic assessment. The overall results were evaluated by Cooney wrist function score and Nakamura scoring system for Kienböck disease.
  
  
  RESULTS
  The 2 groups had no significant difference in pain, motion, grip strength, and radiologic assessment; however, grip strength percentage was better in group 2. There was no significant difference between the radiographic changes of the 2 groups. In group I, 7 out of 9 patients had satisfactory Nakamura scores, and 5 out of 9 patients had satisfactory Cooney scores. All of the patients in group 2 had satisfactory Cooney and Nakamura scores. The difference in the mean Cooney wrist function score in the 2 groups was significant. The difference of Nakamura scores in the 2 groups was not significant.
  
  
  CONCLUSIONS
  Both groups had reasonable long-term outcomes. We were unable to recognize a substantial clinical or radiological difference between the 2 surgical treatments in long-term outcome.
  
  
  METHODS
  Therapeutic III.
authors: Department of Orthopedics, Urmia University of Medical Sciences, Urmia, Iran. afshar_ah@yahoo.com
authors: Ahmadreza
authors: A
authors: Afshar
authors: Karim
authors: K
authors: Eivaziatashbeik
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D012667:Lunate Bone / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D010020:Osteonecrosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging* / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D013524:Surgical Flaps / Q000098:blood supply* / Q000601:surgery*; D055815:Young Adult