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Journal of the Korean Society for Surgery of the Hand 2008;13(3):154-159.
Published online September 1, 2008.
Limited Wrist Arthrodesis for the Advanced Kienbock’s Disease
Seung-Koo Rhee, Seok-Whan Song, Yoo-Joon Sur, Soo-Whan Kang, Sang-Wook Lee, Kyung-Hwan Suhl
부분 관절 유합술을 이용한 진행된 Kienbock 질환의 치료
이승구, 송석환, 서유준, 강수환, 이상욱, 설경환
To compare clinical outcomes of the triscaphe and the scapho-capitate arthrodesis in the advanced Kienbock’s disease. Materials and Methods: Twenty cases, who underwent the triscaphe or the scapho-capitate arthrodesis for treatment of the advanced Kienbo¨ ck’s disease corresponding to Lichtman stage III or IV, were included. The mean follow-up period was 38.2 months (range, 12 to 108 months) and the mean age was 34.8 years (range, 23 to 57 years). The triscaphe and the scapho-capitate arthrodesis were performed in 10 cases respectively. At the last follow-up, range of motion, grip strength, visual analogous pain score, and radiographic changes were evaluated to assess clinical results. Results: The visual analogous pain score after the triscaphe and the scapho-capitate arthrodesis was 4.3 points and 3.1 points, respectively. The grip strength was 71 percent and 77.3 percent, respectively. The total range of motion was 97.5˚(flexion 34˚, extension 40˚, ulnar deviation 15˚, radial deviation 8.5˚) and 113.3˚(flexion 39.3˚, extension 40˚, ulnar deviation 21.7˚, radial deviation 12.3˚). There was no statistically significant difference of all measured items between two groups. The carpal height ratio were preserved and arthritic changes were not seen in neither group. conclusion: The clinical results of the scapho-capitate arthrodesis are similar to those of the triscaphe arthrodesis. Although there is no statistically significant difference between two groups, average value of all items show more favorable results in scapho-capitate arthrodesis group. Considering it's relative easiness, the scaphocapitate arthrodesis seems to be one of good options for treatment of the advanced Kienbock’s disease.

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