- 作者：Yoshiyuki Ando ; Masataka Yasuda ; Kenichi Kazuki ; Noriaki Hidaka ; Yasutaka Yoshinaka
- 关键词：Kienbö ; ck's disease ; adolescent ; temporary scaphotrapezoidal fixation
- 刊名：The Journal of Hand Surgery
- 出版年：2009
- 出版时间：January 2009
- 年：2009
- 卷：34
- 期：1
- 页码：14-19
- 全文大小：460 K
Purpose
There are few therapeutic guidelines for adolescent Kienböck's disease. The purpose of our study was to investigate the clinical and radiographic outcomes of temporary scaphotrapezoidal (ST) joint fixation for adolescent Kienböck's disease.Methods
This was a retrospective review of 6 adolescent patients with Kienböck's disease treated by temporary ST joint fixation. All patients had pain with rest and activity before surgery. The mean patient age at the time of surgery was 14 years, and final follow-up examination was at a mean of 23 months. Under general anesthesia, 2 or 3 K-wires were inserted from the dorsal trapezoid to the scaphoid. The wires were removed at 3 to 6 months.
Results
Mean postoperative wrist extension and flexion were increased from 46° and 48° to 68° and 77°, respectively. These improvements were statistically significant compared with preoperative wrist extension and flexion. Grip strength significantly increased from 52 % to 86 % of the unaffected side. None of the 6 patients had postoperative pain either at rest or with activity. On final follow-up wrist x-ray films, none of the patients had sclerotic change or fragmentation of the lunate, although decreased lunate height remained in all patients. Magnetic resonance imaging revealed improvement to nearly normal intensity of the lunate on T1- and T2-weighted images in all patients.
Conclusions
Both clinical and radiographic outcomes of temporary ST joint fixation for adolescent Kienböck's disease were excellent. We therefore recommend this procedure for the surgical treatment of adolescent Kienböck's disease.
Type of study/level of evidence
Therapeutic IV.