Kakinoki R, Matsumoto T, Suzuki T, Funakoshi N, Okamoto T, Nakamura T
Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, 54 Shougoin Kawahara-cho, Sakyo-ku 606-8507, Japan.
Hand Surg. 2001 Dec;6(2):145-56. doi: 10.1142/s0218810401000618.
We treated eight patients with Kienböck's disease (two patients each with stage 1, 2, 3a and 3b disease by Lichtman's classification) by removing a pedicled, vascularised bone segment from the dorsal aspect of the distal radius and engrafting it into the lunate. Additional shortening of the radius was performed in patients with the ulna-minus or null variant. Shortening of the capitate and capito-hamate fusion were also performed in patients with stage 3 disease. All patients were relieved of their wrist pain at rest and during movement, and the mean grip strength increased from 37% of that in the contralateral hand before surgery to 80% after surgery. The mean post-operative range of motion in the affected wrist was 92% of that in the opposite wrist in patients with stage 1 and 2 disease, and 53% in patients with stage 3 disease. Post-operative assessment revealed that four patients had excellent results, three had good results, and one had a fair result.
