Abstract
Received: June 11, 2015 Revised: [1] July 22, 2015 [2] July 26, 2015 Accepted: July 27, 2015 Correspondence to: Sang Jin Cheon Department of Orthopedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea TEL: +82-51-240-7531 FAX: +82-51-247-8395 E-mail: scheon@pusan.ac.kr Purpose: Our purpose was to assess the results of lunate excision and tendon ball implantation with temporary scaphocapitate fixation for Lichtman stage IIIB Kienbock’s 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 14.5°, and the mean flexion arc improved 8.5°. The mean grip strength was 88% of unaffected side. The mean carpal height ratio was 0.49 preoperatively, 0.47 at final followup. 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 middleaged patients showed satisfactory clinical, functional and radiological results. So this can be a reasonable treatment option.
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