キーンベック病に対する橈骨楔状骨切り術の治療成績

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We treated 14 cases of Kienböck's disease, (Lichtman's Classification; II-5, IIIa-8, IIIb-1) with a closed wedge osteotomy of the radius. Mean duration of follow-up was 3 years and 1 month (1Y-9Y3M). The results according to Nakamura's scoring system were excellent in 3 (21%), good in 10 (71%), fair in 1 (7%) and poor in 0 (0%). However according to Lichtman's criteria ten achieved satisfactony results and four were unsatisfactory.No factors (age, radial inclination, ulnar variance, volar tilt and corrective angle) affected the results but regarding stage at operation, no cases in stage II were unsatisfactory.In radiological assesment, improvement of necrosis of the lunate was seen in almost cases, but carpal height ratio was not improved. In several cases, slightly osteoarthrotic changes were found in the radio-carpal joints and distal radio-ulnar joints. Although these changes did not affect clinical results, careful observation is necessary.In clinical assessment, all cases improved in grip power and range of motion and were subjectively judged to be satisfactory.