Lunate Excision and Tendon Ball Implantation in Lichtman Stage IIIB Kienbock's Disease in Middle-Aged Patients

Cheon,  Sang Jin; Lee,  Dong Ho; Park,  Shi Hwan; Jeon,  Woong Ki

doi:2015.20.3.110

Arch Hand Microsurg > Volume 20(3); 2015 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2015;20(3):110-118.
Published online September 30, 2015.
DOI: https://doi.org/10.12790/jkssh.2015.20.3.110

Lunate Excision and Tendon Ball Implantation in Lichtman Stage IIIB Kienbock's Disease in Middle-Aged Patients

Sang Jin Cheon, Dong Ho Lee, Shi Hwan Park, Woong Ki Jeon

Department of Orthopedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Pusan, Korea. scheon@pusan.ac.kr

Received: 11 June 2015 • Revised: 26 July 2015 • Accepted: 27 July 2015

Abstract

Purpose
Our purpose was to assess the results of lunate excision and tendon ball implantation with temporary scaphocapitate fixation for Lichtman stage IIIB Kienbockos disease in middle-aged patients.

Methods
Ten patients with Lichtman stage IIIB Kienbock's disease who underwent lunate excision and tendon ball implantation and followed up at least 24 months were analyzed. There were 4 males and 6 females. The mean age at the time of surgery was 55.4 years (range, 48-67 years), and follow-up period ranged from 24 to 68 months (mean, 46 months). Radiocarpal joint pain, grip strength, return to daily living activity, range of motion were evaluated and radiologic findings of preoperative, postoperative and last follow-up were evaluated.

Results
All patients returned to daily living activity after 6 months of surgery. At the last follow up, 8 patients had no pain and 2 patients experienced mild pain occasionally. The mean improvement of extension arc was 14.5degrees, and the mean flexion arc improved 8.5degrees. The mean grip strength was 88% of unaffected side. The mean carpal height ratio was 0.49 preoperatively, 0.47 at final follow-up. No patients showed osteoarthritis change at the last follow-up. The mean Cooney's wrist function were 83, 4 patients had excellent, 4 had good, and 2 had fair.

Conclusion
Lunate excision and tendon ball implantation with temporary scaphocapitate fixation for Lichtman stage IIIB Kienbock's disease in middle-aged patients showed satisfactory clinical, functional and radiological results. So this can be a reasonable treatment option.