title: Radial shortening osteotomy for Kienböck disease: minimum 10-year follow-up.
abstract: OBJECTIVE
  To clarify long-term clinical and radiological results more than 10 years after radial shortening osteotomy for Kienböck disease.
  
  
  METHODS
  Eleven wrists of 10 patients that had been classified as Lichtman stages 3A (2 wrists), 3B (8 wrists), and 4 (1 wrist) underwent radial shortening for Kienböck disease. The mean follow-up period was 14.3 years (range, 10-21 y). Clinical outcomes were quantified using the Japanese version of the Disabilities of the Arm, Shoulder, and Hand questionnaire and the modified Mayo wrist score. Radiographic and magnetic resonance imaging studies were performed for 9 of the 10 patients preoperatively and all 10 patients at follow-up.
  
  
  RESULTS
  At follow-up, 6 wrists were asymptomatic and the remaining 5 had mild occasional pain. The mean range of extension and grip strength significantly improved. The mean modified Mayo wrist score and Disabilities of the Arm, Shoulder, and Hand scores were 92 (range, 80-100) and 5 (range, 0-18), respectively. At follow-up, no progression of the Lichtman stage was found in any patient. There was no significant progressive lunate collapse in any patient. The magnetic resonance imaging in 7 wrists showed increased signal intensity of the lunate; the remaining 3 wrists had no alteration in signal intensity of the bone.
  
  
  CONCLUSIONS
  Our study demonstrated satisfactory clinical results after 10 or more years in patients who underwent radial shortening for Kienböck disease. Although we found no improvement in signal intensity of the lunate in 3 wrists, unloading of the diseased lunate after radial shortening gives long-lasting symptom relief and may prevent lunate collapse.
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Hokkaido Orthopaedic Memorial Hospital, Sapporo, Japan; Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Hokkaido Orthopaedic Memorial Hospital, Sapporo, Japan; Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Japan.
authors.forename: Tadanao
authors.initials: T
authors.lastname: Funakoshi
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Hokkaido Orthopaedic Memorial Hospital, Sapporo, Japan; Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Motomiya
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Hokkaido Orthopaedic Memorial Hospital, Sapporo, Japan; Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Urita
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Hokkaido Orthopaedic Memorial Hospital, Sapporo, Japan; Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Minami
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Hokkaido Orthopaedic Memorial Hospital, Sapporo, Japan; Department of Orthopaedic Surgery, Kushiro Rosai Hospital, Kushiro, Japan. Electronic address: niwasaki@med.hokudai.ac.jp.
authors.forename: Norimasa
authors.initials: N
authors.lastname: Iwasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012667:Lunate Bone / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Kienböck disease; MRI signal; long-term study; radial shortening osteotomy