Afshar Ahmadreza, Tabrizi Ali, Aidenlou Ali
Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
J Hand Microsurg. 2020 Apr 7;13(4):243-246. doi: 10.1055/s-0040-1701325. eCollection 2021 Oct.
Kienböck disease after fracture-dislocations around the wrist is a rare occurrence. This case report presents a case of a 66-year-old man who developed Kienböck disease 18 months after his distal ulnar fracture. The patient developed negative ulnar variance after union of the distal ulnar fracture. Nonsurgical treatment was not effective in relieving his pain. Radial shortening osteotomy was performed based on the negative ulnar variance that developed. One year postoperatively, visual analog scale improved to 0, grip strength improved to 25 kg, and flexion-extension arc improved to 150 degrees. The patient achieved satisfactory clinical outcomes. This is a therapeutic level IV study.
腕关节周围骨折脱位后发生的月骨无菌性坏死较为罕见。本病例报告介绍了一名66岁男性,在尺骨远端骨折18个月后发生月骨无菌性坏死。该患者尺骨远端骨折愈合后出现尺骨负变异。非手术治疗未能有效缓解其疼痛。基于出现的尺骨负变异进行了桡骨缩短截骨术。术后一年,视觉模拟评分改善至0分,握力提高到25千克,屈伸弧度改善至150度。患者获得了满意的临床疗效。这是一项IV级治疗性研究。