Metaphyseal bone decompression of distal radius for early stages of Kienbock's disease. Minimum follow-up of 10 years.

• Main Authors: Ezequiel Ernesto Zaidenberg, Pablo De Carli, Jorge Guillermo Boretto, Agustin Donndorff, Veronica Alfie, Gerardo Luis Gallucci, Aldo Illaramendi
• Format: Article
• Language: English
• Published: Asociacion Argentina de Ortopedia y Traumatologia 2018-02-01
• Series: Revista de la Asociación Argentina de Ortopedia y Traumatologia
• Subjects: Kienbock; descompresión ósea; largo plazo; estadios tempranos. Kienböck; bone decompression; long-term results; early stages
• Online Access: https://ojs.aaot.org.ar/ojsr/index.php/AAOTMAG/article/view/757

Background The purpose of this study is to analyze the long-term clinical and radiological results of a series of patients with early stages of the Kienbock disease treated with radius core decompression. Methods This retrospective study included 23 patients with Kienböck’s disease (Lichtman stage II and IIIA) who underwent distal radius metaphyseal core decompression that were followed-up for at least 10 years. At the last follow-up, the patients were evaluated for wrist range of motion and grip strength. The overall results were evaluated by the modified Mayo wrist score and visual analogue scale pain score. We also compared the radiological changes between the preoperative and final follow-up in their Lichtman classification and the modified carpal height ratio. Results The mean follow-up period was 13 years (range 10-18). Based on the modified Mayo Wrist Score, clinical results were excellent in 9 patients, good in 11 patients, fair in 2 and poor in one patient. The mean preoperative pain according to VAS was 7 (range 6-10) and was 1.1 (range 0-6) at the final follow-up. Compared with the opposite side, the average flexion/extension arc was 78% and the grip strength was 81%. Radiographic disease progression according to the Lichtman classification occurred in four wrists. Conclusion This long-term follow-up study shows that radius core decompression is a valid alternative for the treatment of the early stages of the kienbock disease.