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Long-Term Follow-Up After Wrist Surgery for Kienböck's Disease
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Posted on: 11/30/1999
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This study is the only one of its kind. It reports on the long-term results of patients who have all had the same wrist surgery for Kienböck's disease. This condition is a disorder of the wrist named for Dr. Robert Kienbock, a radiologist in Vienna, Austria. He was the first one to describe the problem back in 1910.
Kienböck's disease is breakdown of the lunate bone. The lunate is a small bone in the wrist on the little finger side of the hand. It forms part of the wrist joint where it connects with the radius (bone in the forearm).
Blood supply to the area is interrupted. The bone starts to die and dissolves or fractures. Another name for this condition is avascular necrosis. There are many ways to treat this problem. Sometimes the wrist bones are fused together. In other cases a joint replacement is ideal. Trying to restore blood flow to the area in a procedure called revascularization is also possible. Removing the lunate and/or other bones in the wrist may be advised.
All patients in this study had a proximal row carpectomy (PRC). This means a row of wrist bones closest to the forearm was surgically removed (including the lunate). The follow-up period was no less than 10 years after surgery. The range of years for follow-up among the group was from 11 to 20 years.
Range of motion, grip strength, and function were measured and compared before and after surgery. The values for each of these outcomes were also compared from one side to the other. Overall values improved for all measures. Results were excellent or good with no treatment failures. These results were maintained by everyone out to an average of 15 years after the operation.
The authors suggest that PRC is a reliable motion-preserving procedure for the management of advanced Kienböck's Disease. Patients were able to return to work without changing jobs. Some patients experienced pain with overuse or lifting but did not report this as disabling.
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References:
Boyd C. Lumsden, MD, et al. Treatment of Advanced-Stage Kienböck's Disease with Proximal Row Carpectomy: An Average 15-Year Follow-Up. In The Journal of Hand Surgery. April 2008. Vol. 33A. No. 4. Pp. 493-502.
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