The Surgical Procedures to Treat Advanced Kienböck’s Disease

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Journal of the Korean Society for Surgery of the Hand 2002;7(1):108-116.
Published online January 1, 2002.

Seung-Koo Rhee, Seok-Whan Song, Jin-Wha Chung, Yoo-Joon Sur

진행된 Kienböck 질환의 수술적 치료

이승구, 송석환, 정진화, 서유준

Abstract

Purpose
: To analyse long-term end results of various common treatments of advanced Kienböck’s disease and to try to find the best way for its treatment. Materials and Methods : Since 1985, we treated 25 cases of advanced Kienböck’s disease, stage Ⅲ and Ⅳ by Lichtman’s classification, with triscaphe fusion associated with or without bone graft on lunate (10 cases), tendon ball replacement arthroplasty after excision of lunate with (2 cases) or without (4 cases) triscaphe fusion, proximal row carpectomy (3 cases), limited intercarpal fusion (4 cases) and antero-posterior wiring with vascularized bone graft (2 cases), and followed them for minimal of 16 months (average 44 months) after each operation. Results : Various treatment methods resulted various end results. No method resulted complete preservation of functional ability and complete remission of symptoms. All patients returned to their occupation about 7 months after operation. Conclusion : All the ways of treatment for advanced Kienböck’s disease had their own advantages and disadvantages, and so there is no single way to treat them. The best way to treat advanced Kienböck’s disease should be decided according to the patient’s age, sex, their job, and the radiologic status of disease.

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