Back

Temporary Scaphotrapezoidal Joint Fixation Provides Excellent Outcome in Adolescent Kienbock's Disease

Kienbock's disease, a condition where the lunate bone in the wrist is deprived of blood, is usually found in adults from 20 years old to 40. Although it's rare, the disease does happen in adolescents (older children and teens) however, and guidelines for treatment are few and far between.

When the blood supply to the lunate is cut off, the bone cells are deprived of nutrition and they begin to die. This causes pain in the wrist and difficulty moving it. Treatment usually involves surgery, but with no guidelines for children and teens, the authors of this article investigated the outcomes of teens who were treated by having a temporary joint fixation.

The researchers followed six adolescents who were between 9 and 17 years old when they had surgery (the joint fixation) because of Kienbock's disease. Two of the patients had been treated with splints before the surgery. After a follow up of between seven to 48 months, the researchers checked to see how the patients were doing. The researchers measured how much the adolescents could bend and extend their wrist, tested the grip strength and asked about the pain levels. X-rays and magnetic resonance images were also taken and compared with copies from before the surgery.

The results showed that the adolescents were able to bend and extend their wrist significantly better after surgery than before, as did the grip strength. All six patients reported good relief from pain. There were complications with one patient - the pins used to fix the joint became infected, but this was treated with antibiotics. Another patient had to have the surgery done again as there was movement of the hardware in the wrist.

The x-rays showed that the area no longer had any signs of active disease.

The authors concluded that this approach was effective and provided excellent outcomes in children and teens who develop Kienbock's disease.

References: Yoshiyuki Ando, MD, et al. Temporary Scaphotrapezoidal Joint Fixation for Adolescent Kienbock's Disease. In Journal of Hand Surgery January 2009. Vol. 34A. Pp. 14 to 19.

Back