Long-term Follow-up of Radial Shortening and STT Arthrodesis in Kienböck Disease

Abstract

Purpose: The purpose of the study is to assess the long-term results of radial shortening and scaphoid-trapezium-trapezoid (STT) arthrodesis performed in the same surgical procedure to treat Kienböck disease stage IIIB and negative ulnar variance. Methods: Twenty patients with Kienböck disease in stage IIIB and negative ulnar variance were studied between August 1999 and December 2012. Patients were classified according to Lichtman’s classification. Stage distribution was 20 patients in stage IIIB. All patientes had negative ulnar variance. The average follow-up was 8 years and 4 months. The review includes assessment of pain, swelling, mobility of the wrist, grip strength, carpal height, and patient satisfaction. Results: Twenty patients with an average age of 28 years (range, 14-35) were studied. The pain improved markedly (2.25 visual analogue scale, range, 0-10). The flexion, extension, radial deviation, and ulnar deviation also improved. No wrist movement declined compared with preoperative values. Grip strength increases over the preoperative average of 26.6 kg to 34.6 kg. Carpal height ratio remained constant, indicating no increase in carpal collapse. The degree of patient satisfaction was high according Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Conclusions: According to the results obtained in our study, the STT arthrodesis with radial shortening osteotomy performed in the same surgical is a good option for the treatment of Kienböck disease stage IIIB and negative ulnar variance.