Long-term Results of Limited Intercarpal Arthrodesis Combined with Lunate Excision and Rolled-Tendon Arthroplasty In Advanced Kienböck Disease – Scaphocapitate or Hamatocapitate Arthrodesis –

Journal of the Korean Society for Surgery of the Hand 2002;7(1):42-47.
Published online January 1, 2002.

Kwang-Suk Lee, Kwang-Jun Oh, Woo-Jin Yeo, Hyung-Suk Song, Sung-Joon Park

진행된 Kienböck 질환에서 월상골 제거술 및 건 충진술을 병행한 제한적 수근골간 유합술의 장기 추시 결과 - 주상-유두골 또는 유구-유두골 유합술 -

이광석, 오광준, 여우진, 송형석, 박성준

Abstract

Purpose
: This report is a review on the findings of a long term postoperative follow-up of treated with limited intercarpal arthrodesis combined with lunate excision and rolled tendon arthroplasty in advanced Kienböck’s disease (Lichtman stage Ⅲ) for more than 7 years of follow-up study. Material and Method : Spanning from May 1987 to January 1995, patients were available for long term postoperative follow up from seven years to ten years. Of the five patients performed with limited intercarpal arthrodesis combined with lunate excisional arthroplasty with rolled tendon, three of the patients had a scaphocapitate fusion, other two patients had a capitohamate arthrodesis. Scoring for the outcome of the surgery was based on clinical finding such as pain, grasping power, ROM of wrist, return to job and radiologic findings. Results : In observing the therapeutic results, two out of five patients were satisfied, the remaining three unsatisfied. Three out of five cases were occurred in severe degenarative change and painful motion of wrist joint. All patients had improvement of grasping power and ROM of wrist following surgery. The radiologic findings of long term follow ups showed no change of carpal height and intercarpal relationship. Conclusion : Even though the lunate excision and rolled tendon arthroplasty with limited intercarpal arthrodesis were considered to maintain the biomechanical intercarpal joint in Lichman stage III, Kienböck’s disease, the clinical results of long term follow-up were unsatisfactory.