CLOSING RADIAL WEDGE OSTEOTOMY FOR PREISER'S COMBINED WITH KIENBÖCK'S DISEASE: TWO CASE REPORTS

Hand Surgery ◽  
2009 ◽  
Vol 14 (01) ◽  
pp. 57-62 ◽  
Author(s):  
Ousuke Hayashi ◽  
Takuya Sawaizumi ◽  
Hiromoto Ito
Keyword(s):  
Avascular Necrosis ◽  
Clinical Evaluation ◽  
Early Stage ◽  
Case Reports ◽  
Carpal Bone ◽  
Wedge Osteotomy ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Appropriate Treatment ◽  
Kienbock’S Disease

Avascular necrosis involving more than one carpal bone is rare, and the appropriate treatment for this condition has not yet been established. In this report, two patients with concomitant Preiser's and Kienböck's disease who also had severe wrist pain without obvious traumas were treated by closing radial wedge osteotomy (CRWO). Clinical evaluation showed that CRWO was effective against both conditions and indicated that it is more suitable for early stage than stage II diseases of the Hebert and Lichtman classifications.

Radial Shortening or Radial Wedge Osteotomy for Kienbock's Disease

1997 ◽  
Vol 32 (1) ◽  
pp. 133
Author(s):  
Ik Dong Kim ◽  
Joo Chul Ihn ◽  
Poong Taek Kim ◽  
Hee Soo Kyung ◽  
Seung Ho Shin
Keyword(s):  
Wedge Osteotomy ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Kienbock’S Disease

scholarly journals Evaluation of Kienböck's Disease Treated by Camembert Osteotomy at Seven Years

2019 ◽  
Vol 08 (03) ◽  
pp. 226-233 ◽  
Author(s):  
Emmanuel J. Camus ◽  
Luc Van Overstraeten
Keyword(s):  
Case Series ◽  
Ulnar Variance ◽  
Wedge Osteotomy ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Ulnar Shortening Osteotomy ◽  
Case Series Study ◽  
Shortening Osteotomy ◽  
Functional Scores ◽  
Kienbock’S Disease

AbstractIn Kienböck's disease, radius shortening osteotomy is the most common treatment. The Camembert procedure is a wedge osteotomy that shortens only the radius facing the lunate. Its aim is to offload the lunate by redirecting the compression stress of the grip forces toward the scaphoid. The purpose of this study was to determine if the Camembert osteotomy is effective in improving clinical symptoms and limits lunate collapse. The series include 10 patients who underwent a Camembert osteotomy for Kienböck's disease between 2002 and 2012 (one bilaterally). They are six men and four women, aged 40.6 years. Five patients had an additional ulnar shortening osteotomy if ulnar variance was neutral or positive. The mean follow-up is 7 years. Preoperatively, range of motion, grip strength, pain, and functional scores were poor. All osteotomies healed within 3 months. Extension, ulnar deviation, grip, functional scores improved significantly. In 10 cases, there were improvement in the T1 and T2 signals on the magnetic resonance imaging (MRI). There was no lunate collapse. This series shows good results with no worsening of the lunate shape. There was no ulnocarpal impingement. The Camembert osteotomy proposes to offload the lunate and redirect strains toward the scaphoid. The supposed interest is to protect the lunate from collapse. In this small series, the Camembert osteotomy improved function in patients with early stage Kienböck's disease. MRI aspects improve in most cases and no patients collapsed. Camembert can be used in combination with a Sennwald's ulnar shortening when ulnar variance is neutral or positive. Authors propose this procedure for Lichtman's stages 1–2–3A if there are no cartilage or ligament lesions. This is a Level IV, case series study.

Radial Closing Wedge Osteotomy for Kienböck’s Disease: an Over 10 Year Clinical and Radiographic Follow-Up.

2002 ◽  
Vol 27 (2) ◽  
pp. 175-179 ◽  
Author(s):  
A. WADA ◽  
H. MIURA ◽  
H. KUBOTA ◽  
Y. IWAMOTO ◽  
Y. UCHIDA ◽  
...  
Keyword(s):  
Long Term Results ◽  
Wedge Osteotomy ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Closing Wedge Osteotomy ◽  
Radial Inclination ◽  
Closing Wedge ◽  
Joint Contact ◽  
Kienbock’S Disease

Thirteen patients with Kienböck’s disease who had undergone a radial closing wedge osteotomy were reviewed clinically and radiologically at a follow-up mean of 14 years. Good long-term results were obtained in all patients. Their levels of pain were improved, and significant increases were seen in the range of motion and grip strength. Radiographic stage, as assessed by Lichtman’s classification, improved in one, did not change in four, and advanced in eight patients. The radial inclination angle significantly decreased and the carpal-ulnar distance and lunate covering ratios both increased, demonstrating that radial shift in the alignment of the carpal bones occurs and that the joint contact area of the lunate increases in proportion to the decrease in radial inclination. The preoperative radiolunate and radioscaphoid angles, which were significantly larger than those of the unaffected wrist, did not change postoperatively which shows that this technique was not able to correct the flexion deformity of the lunate and the scaphoid.

Histopathology of Kienböck’s Disease

1996 ◽  
Vol 21 (1) ◽  
pp. 89-93 ◽  
Author(s):  
H. HASHIZUME ◽  
H. ASAHARA ◽  
K. NISHIDA ◽  
H. INOUE ◽  
T. KONISHIIKE
Keyword(s):  
Early Stage ◽  
Granulation Tissue Formation ◽  
Bone Necrosis ◽  
Lunate Bone ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Reactive Interface ◽  
Histopathological Studies ◽  
Kienbock’S Disease

Histopathological studies of extracted whole lunate bones obtained from 10 patients with Stage 3 Kienböck’s disease at surgery for tendon-ball replacement were correlated with magnetic resonance imaging (MRI), computed tomography (CT) and tomography images made prior to surgery. A reforming zone, or a reactive interface between the reactive new bone and granulation tissue formation, and new vascularization were observed surrounding the bone necrosis area showing empty lacunae, fatty necrosis, and disappearance of osteoid. Findings of CT, tomography and microradiography of slices of extracted lunate bone confirmed that fractures of the articular cartilage and the subchondral bone occurred secondarily by overloading, and showed the extent of the collapsed area of the lunate. MRI showed complete loss of signal intensity in T1 images of the lesion of the lunate in advanced Stage 3 Kienböck’s disease. MRI is at present unable to distinguish bone necrosis, the histological reactive interface or surrounding hyperaemia in detail. However, the low-intensity arc, or the reactive interface present on MRI in early Stage 3, sometimes correlates with the histological findings of osteoid and granulation zones.

Bilateral Kienböck’s Disease

2005 ◽  
Vol 30 (2) ◽  
pp. 133-136 ◽  
Author(s):  
N. YAZAKI ◽  
R. NAKAMURA ◽  
E. NAKAO ◽  
Y. IWATA ◽  
M. TATEBE ◽  
...  
Keyword(s):  
Risk Factor ◽  
Retrospective Review ◽  
Systemic Disease ◽  
Ulnar Variance ◽  
Carpal Bone ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Bilateral Disease ◽  
Radiographic Parameters ◽  
Kienbock’S Disease

We conducted a retrospective review of 11 patients with bilateral Kienböck’s disease from our series of 251 patients with Kienböck’s disease. There were no significant differences in radiographic parameters, including ulnar variance and carpal bone angle, between those with unilateral and those with bilateral Kienböck’s disease. None of the patients with bilateral disease had been treated with corticosteroids or had a systemic disease that predisposed to osteonecrosis. Thus, this study failed to demonstrate any risk factor for bilateral, as opposed to unilateral Kienböck’s disease.

Existing or Worsening Symptoms of Kienböck’s Disease after Distal Radius Fracture: Two Case Reports

2018 ◽  
Vol 23 (04) ◽  
pp. 585-588
Author(s):  
Takeshi Ogawa ◽  
Shunsuke Asakawa
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Reports ◽  
Combined Therapy ◽  
Compression Fracture ◽  
Radius Fracture ◽  
Lunate Bone ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Kienbock’S Disease

We report two rare cases of existing or worsening symptoms due to Kienböck’s disease after distal radius fracture (DRF). During examination, radiographs show changes in the lunate bone; there was persistent wrist pain after treatment for DRF. In each case, surgeries were performed: A combined therapy (bone marrow transfusion, bone peg graft, external fixation, and low intensity pulsed ultrasound) for one, as well as carpal coalition for another. The etiology of these case presentations suggest that a compression fracture of the lunate due to a DRF resulted in softening and sclerosis.

Sign in / Sign up

Export Citation Format

Share Document