Comparison of Clinical and Radiological Outcome of Radial Shortening and Capitate Shortening in the Early Stages of Kienböck Disease

Abstract

Background: This study aims to compare the clinical and radiological outcomes of radial shortening osteotomy (RSO) and capitate shortening osteotomy (CSO) in the early stages of Kienböck disease. Methods: Grip strength and wrist range of motion were assessed bilaterally. Also, the disease stage in pre-op and the final follow-up were determined. Quick-DASH, Patient-Rated Wrist Evaluation (PRWE), and Modified Mayo Wrist Score were used to assess patient comfort and function.Results: 23 patients were followed up (13 patients with RSO and 10 patients with CSO) for mean 46 months. Affected wrist range of motion in flexion and extension and grip strength was significantly lower than the unaffected side. Pain score in the Mayo wrist questionnaire was significantly lower in the RSO group than CSO group. The failure rate was 1.16% and 2.59% per year for RSO and CSO, respectively. Radiologic stage worsened in two patients (one in each RSO and CSO groups) and it was improved in nine patients (six in RSO and three in CSO groups). Six patients (three in each RSO and CSO groups) underwent revision surgeries due to residual pain. As expected, wrist motion arc and grip strength were significantly more limited in these patients in comparison to others (p=0.031 and p=0.026, respectively).Conclusion: We found no significant differences between the two groups in terms of clinical findings, patients’ function and satisfaction, and success rate. Level of evidence: III - Retrospective cohort study