Clinical Outcomes of Radial Shortening Osteotomy and Vascularized Bone Graft in Kienböck’s Disease

Dehghani, Mohammad; Moshgelani, Mohammad Ali; Nouraei, Mohammad Hadi; Dehghani, Sirous; Gholshahi, Maryam

doi:10.1155/2014/956369

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…Dehghani et al concluded from their randomized study that a combination of radial shortening and vascularized bone grafting is more efficient than shortening alone in terms of Mayo Wrist Score. 26 The follow-up in that study was only 9 months. Table 4 summarizes the literature on outcome of radial shortening osteotomy for symptomatic Kienböck's disease with average follow-up duration of more than 10 years.…”

Section: Discussionmentioning

confidence: 90%

Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome

et al. 2020

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Objective To determine the rate of salvage procedures and any other unplanned reoperations in patients with symptomatic Kienböck's disease who were treated with radial shortening osteotomy. In addition, we studied patient-reported outcome in the long term using Patient-Reported Outcome Measure Information System (PROMIS) instruments. Methods We performed a retrospective review of all patients who underwent radial shortening osteotomy for stage 2 and 3A Kienböck's disease. Patients who had concomitant revascularization were grouped separately. We collected demographic data, data regarding type of surgery and reoperations, and radiographic data. Patient-reported outcome measures were the PROMIS Upper Extremity Computer Adaptive Testing (CAT) and Pain Interference instruments, the abbreviated Disabilities of Arm, Shoulder, and Hand (QuickDASH), and the 0 to 10 numeric rating scale for pain and satisfaction. Results We included 48 patients who had radial shortening osteotomy alone, and 17 patients who had a combined procedure of radial shortening and direct revascularization. The rate of unplanned reoperations was 33% (16 of 48) in those who had radial shortening osteotomy and 24% (4 of 17) in those who had a combined procedure. Six (13%) of 48 patients underwent proximal row carpectomy due to failed radial shortening osteotomy. No salvage procedures were performed after combined radial shortening/revascularization. Median PROMIS Physical Function CAT scores were 56 (interquartile range [IQR]: 44–56) and 56 (IQR: 41–56), respectively. Median PROMIS Pain Interference scores were 39 (IQR: 39–52) and 39 (IQR: 39–49), respectively. Median QuickDASH scores were 2.3 (IQR: 0–23) and 4.5 (IQR: 2.3–14), respectively. Conclusion Radial shortening osteotomy for symptomatic Kienböck's disease yields reasonable long-term function. We observed that approximately one in eight patients underwent salvage surgery after radial shortening, and this should be taken into account when making the initial decision to treat Kienböck's disease surgically. There appeared to be no benefit of direct revascularization in addition to radial shortening in terms of patient-reported outcome in the long term. Level of Evidence This is a Level IV, therapeutic study.

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Section: Discussionmentioning

confidence: 90%

Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome

et al. 2020

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“… 10 , 11 , 12 , 13 One study reported 2 mm of shortening, two studies reported an RS of up to 2 mm and 3 mm, and one study reported 2–5 mm of shortening. 14 , 15 , 16 , 17 One study performed RS to achieve neutral to (−1) ulnar variance. 18 …”

Section: Resultsmentioning

confidence: 99%

Novel Descriptions of the Radial Osteotomy in Kienböck’s Disease: A Systematic Review

Heifner¹,

Halpern²,

Zavurov³

et al. 2023

Journal of Hand Surgery Global Online

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“…In these studies, radial shortening is considered the treatment of choice for stage I to IIIA of Kienböck's disease. 7,[15][16][17] On the other hand, capitate shortening can reduce pain and enhance the wrist's function and ROM and grip strength effectively. The result of the current trial is consistent with the results of the studies by Schuind et al 7 and Cross and Matullo.…”

Section: Discussionmentioning

confidence: 99%

“…In these studies, radial shortening is considered the treatment of choice for stage I to IIIA of Kienböck’s disease. 7,15-17…”

Section: Discussionmentioning

confidence: 99%

Comparing the Radiologic and Functional Outcome of Radial Shortening Versus Capitate Shortening in Management of Kienböck’s Disease

Mazhar

Motaghi

Kooshesh

et al. 2022

Hand (New York, N,Y.)

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Background: Kienböck’s disease is the avascular necrosis of the lunate bone. There is no consensus on the treatment strategy to avoid joint deterioration. This trial is conducted to compare the functional and radiological outcomes of radial shortening and capitate shortening techniques, in patients with avascular necrosis of lunate. Methods: Patients with a confirmed diagnosis of Kienböck’s disease who met the inclusion criteria were randomly divided into radial shortening and capitate shortening groups and treated by allocated technique. Physical examination and radiologic evaluations were performed before and 6 and 12 months after the operation. Results: A total of 52 patients (52 wrists) of stage II or III Kienböck’s disease were assessed for eligibility, 12 patients in the radial shortening group, and 17 patients remained until the end of the study. Patients in both groups achieved a satisfactory outcome, with no report of postoperative complications. None of the outcome measures, ranges of motion, grip, and pinch strengths were significantly different between the groups. The outcome was not considerably different in patients with positive or negative ulnar variances who were treated by capitate shortening technique. Conclusions: The capitate shortening technique which is performed through a smaller incision, and takes less time as compared with radial shortening can be advantageous for patients with stage II or III Kienböck’s disease regardless of the ulnar variance. This method can be as effective as classical methods such as radial shortening in improving clinical and functional symptoms after surgery while causing fewer complications.

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Clinical Outcomes of Radial Shortening Osteotomy and Vascularized Bone Graft in Kienböck’s Disease

Cited by 6 publications

References 22 publications

Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome

Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome

Novel Descriptions of the Radial Osteotomy in Kienböck’s Disease: A Systematic Review

Comparing the Radiologic and Functional Outcome of Radial Shortening Versus Capitate Shortening in Management of Kienböck’s Disease

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