title: Outcome of Kienböck's disease in twelve cases: a mid-term follow-up study.
abstract: BACKGROUND
  No single study has established the superiority of one treatment of Kienböck's disease over the other. Pooled outcome data is presently considered the best way to add to the knowledge and understanding of Kienböck's disease.
  
  
  METHODS
  A total of 12 patients (9 male and 3 female) with Kienböck's disease were included in the present case series. The mean age of the 12 patients was 28 years. One patient presented in Lichtman stage I, five in Lichtman stage II, five in Lichtman stage IIIa, and one in Lichtman stage IV. Univariate and multivariate analyses of the obtained data were performed to identify any correlations.
  
  
  RESULTS
  The mean follow-up time was 62 months, and the mean modified Mayo wrist score improved from the preoperative value of 29.5 to the final value of 89.6. Lichtman stage at presentation showed moderate positive correlation with the duration of symptoms (r = 0.56), and a strong negative correlation with the preoperative and final modified Mayo scores (r = -0.89 and r = -0.77, respectively). The final modified Mayo score showed moderate negative correlation with the duration of the symptoms (r = -0.55). There was a significant difference in the preoperative modified Mayo scores of patients who presented in stage II and those of patients who presented in stage IIIa (p = 0.03). However, the difference in the final modified Mayo scores of the patients in these stages was not significant (p = 0.14).
  
  
  CONCLUSIONS
  Lichtman's stage is moderately related to the duration of symptoms, suggesting natural progression of the disease. The final outcomes of stages II and IIIa were the same irrespective of the surgical treatment (radial shortening and/or vascularised bone grafting).
authors: Ravi
authors: R
authors: Gupta
authors: Department of Orthopaedics, Government Medical College and Hospital, Sector 32, Chandigarh 160030, India. manishpruthi@gmail.com.
authors: Manish
authors: M
authors: Pruthi
authors: Amit
authors: A
authors: Kumar
authors: Sudhir
authors: S
authors: Garg
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007596:Joints / Q000601:surgery; D008297:Male; D010020:Osteonecrosis / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult
references: J Hand Surg Am. 2010 May;35(5):713-7, 717.e1-4
references: 20438990
references: J Hand Surg Am. 1980 May;5(3):272-8
references: 7400565
references: J Wrist Surg. 2013 Feb;2(1):1-4
references: 24436782
references: J Hand Surg Am. 2011 Oct;36(10):1675-7
references: 21835555
references: J Hand Surg Br. 1998 Feb;23(1):33-6
references: 9571476
references: J Hand Surg Br. 1986 Feb;11(1):98-102
references: 3958561
references: J Bone Joint Surg Am. 1982 Feb;64(2):170-8
references: 7056768
references: Clin Orthop Relat Res. 1980 Jun;(149):4-8
references: 6996884
references: Microsurgery. 2009;29(5):373-8
references: 19530091
references: J Hand Surg Am. 1979 Jan;4(1):23-33
references: 759500
references: J Hand Surg Am. 2005 Jan;30(1):50-8
references: 15680555
references: J Hand Surg Eur Vol. 2010 Sep;35(7):549-54
references: 20621943
references: J Bone Joint Surg Am. 1977 Oct;59(7):899-908
references: 908720
references: Handchir Mikrochir Plast Chir. 1996 Jul;28(4):215-9
references: 8964554
references: J Hand Surg Am. 1982 Jul;7(4):348-52
references: 7119393
references: Tech Hand Up Extrem Surg. 2011 Mar;15(1):55-65
references: 21358527
references: Acta Orthop Scand. 1963;33:43-55
references: 13929121