Iwasaki N, Minami A, Oizumi N, Suenaga N, Kato H, Minami M
Department of Orthopaedic Surgery, Hokkaido University School of Medicine and Hokkaido Orthopaedic Memorial Hospital, Sapporo, Japan.
J Bone Joint Surg Br. 2002 Jul;84(5):673-7. doi: 10.1302/0301-620x.84b5.12589.
We have reviewed 20 patients with stage-IIIB and stage-IV Kienböck's disease in order to examine the efficacy of two forms of radial osteotomy, namely radial wedge osteotomy and radial shortening. Lateral closing wedge osteotomies and radial shortenings were carried out on 11 and nine patients, respectively. There were no preoperative differences with respect to age, gender, and radiological stage. After a mean follow-up of 29 months, all patients, in both groups, had either a good or an excellent outcome. After the lateral closing wedge osteotomy, the radioscaphoid angle significantly increased and the Ståhl index significantly decreased. Progression of the degenerative changes at the radioscaphoid joint was found in two patients in this group. By contrast, there were no significant changes in any radiological parameters after radial shortening. Both procedures gave acceptable clinical results in stage-IIIB and stage-IV Kienböck's disease.
我们回顾了20例IIIB期和IV期月骨无菌性坏死患者，以研究两种桡骨截骨术的疗效，即桡骨楔形截骨术和桡骨短缩术。分别对11例和9例患者实施了外侧闭合楔形截骨术和桡骨短缩术。两组患者在年龄、性别和放射学分期方面术前无差异。平均随访29个月后，两组所有患者的预后均为良好或优秀。外侧闭合楔形截骨术后，桡舟角显著增加，施塔尔指数显著降低。该组有2例患者出现桡舟关节退变进展。相比之下，桡骨短缩术后任何放射学参数均无显著变化。两种手术方法在IIIB期和IV期月骨无菌性坏死中均取得了可接受的临床效果。
