Radial Shortening Osteotomy Using Volar Locking Plate for Kienböck's Disease

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Purpose:The purpose of this study was to report the preliminary results for radial shortening osteotomyfollowed by volar locking plate fixation without post-operative immobilization for the treatment of Kienböck'sdisease.Methods:Ten consecutive patients with Kienböck's disease of stages III were treated by radial shorteningosteotomy at the metaphysis using a volar locking plate system. Radial shortening osteotomy was performedfor patients with negative or neutral ulnar variance, and combined shortening of radius and ulna forthose with positive ulnar variance. The active motion of the digits, wrist, and forearm was encouraged immediatelyafter surgery, and no splints were used.Results:The average follow-up was 26 months. In all the patients, the osteotomized bone united after anaverage of 11 weeks. Follow-up radiographs showed no further progression of the disease in carpal height,Ståhl's index, or Lichtman's stage classification. Moderate pain reported by all the patients preoperativelysignificantly improved by the final follow-up. Wrist extension, flexion, grip strength, and the Mayo wristscore were significantly improved compared with preoperative values.Conclusions:Volar locking plate fixation without immobilization is a safe and effective procedure for radialshortening osteotomy of Kienböck's disease.
獨協医科大学の論文
2012-03-25