Partial Capitate Shortening Osteotomy and Its Impact on Lunate Revascularization: Mid-Term Results

Abstract

Background: Treatment of Kienbö ck disease is still a clinical challenge. The treatment used in each instance is decided according to stage of the disease at presentation. Good clinical and radiological results could be obtained with partial capitate shortening osteotomy. However, mid-term results of this technique and its effect on lunate revascularization are not well known. Objectives: The aim of this study was to report our results of partial capitate shortening osteotomy in the treatment of stage II and IIIA Kienbö ck disease. Methods: Ten patients were enrolled in the study with a mean age of 37.7 years old (standard deviation [SD] ¼ 9.6). Patients were evaluated clinically in terms of range of motion, DASH and VAS scores, satisfaction with the outcome, and grip/tip/palmar/key pinch strength compared to the contralateral side. Radiological evaluation consisted of Lichtman staging on plain radiographs and lunate revascularization on magnetic resonance imaging (MRI) at both preoperative and postoperative evaluations. Results: The mean duration of follow-up was 55.2 (SD ¼ 24) months. The mean DASH and VAS scores were 14.3 (SD ¼ 6.7) and 1.5 (SD ¼ 1.3), respectively. For patient satisfaction, the mean score was 3.6 (SD ¼ 0.6). The Lichtman stage of 7 patients remained unchanged. Lunate revascularization was detected with MRI in 6 patients. Conclusions: Although the number of patients in the study prevents more strict conclusions, our results are promising, and the technique presented offers minimally but observable lunate revascularization and high success rates in preventing the progression of the disease.

Kienböck's Diseases Treatment. A Novel Technique via Distal Capitate Shortening Accompanied by 3rd Metacarpal Base Fusion in Neutral Variance Ulna

“…Another study was performed on 10 patients 3 cases were stage II and 7 cases were III, achieved lunate revascularization which was detected by MRI in 6 patients. [23] In a study that used the same technique of treatment for Kienböck's disease [11] as those in group IIIA, and these results were also reported in other studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24] .…”

Functional and radiological results of partial capitate shortening osteotomy in the treatment of Kienböck’s disease

“…There are three case series that report the clinical results of PCSO (Citlak et al., 2015; Singer et al., 2017; Tahta et al., 2019). Citlak et al.…”

“…There are three case series that report the clinical results of PCSO (Citlak et al, 2015;Singer et al, 2017;Tahta et al, 2019). Citlak et al (2015) reported the results of seven patients, with a mean 38 months follow-up.…”

“…The surgical technique includes partial shortening of the capitate without disrupting the scaphocapitate relationship, and thus does not affect scaphocapitate and midcarpal dynamics (Moritomo et al, 2004). Several studies have shown that PCSO yields good clinical outcomes and has a positive affect on wrist motion and strength, but the current evidence is limited (Citlak et al, 2015;Singer et al, 2017;Tahta et al, 2019). In this study, we report our experience with PCSO and the functional and radiological outcome in the patients.…”

Surgical Treatment of Patient with Advanced Kienböck’s Disease: A Case Report

“…Разработано множество способов лечения указанного заболевания, ни один из которых не позволяет добиться стабильно хороших результатов [6]. С этой целью выполняются различные варианты костной пластики кровоснабжаемыми и некровоснабжаемыми трансплантатами, пересаживаемыми как в свободном, так и в несвободном варианте, в том числе с использованием стволовых мезенхимальных клеток, остеотомий лучевой и головчатой костей, частичного или тотального артродеза кистевого сустава, его эндопротезирования либо пластики полулунной кости костным цементом [6,7,8,9,10,11,12,13,14,15,16,17,18]. Во многом тактика оперативного лечения основана на рентгенологической картине изменений самой полулунной кости и близлежащих костей кистевого сустава.…”