Lunate fracture healing after partial capitate shortening in Kienböck disease.
Journal
Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
ISSN: 1436-2023
Titre abrégé: J Orthop Sci
Pays: Japan
ID NLM: 9604934
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
17
12
2018
revised:
06
06
2019
accepted:
09
06
2019
pubmed:
8
7
2019
medline:
21
11
2020
entrez:
8
7
2019
Statut:
ppublish
Résumé
It is unclear whether lunate fracture types in Kienböck disease correlate with the degree of fracture healing. This study aimed to review the clinical results of stage 3 Kienböck disease treated using partial capitate shortening (PCS) and to evaluate the healing rates of lunate fractures based on the fracture types. Twenty-three patients were clinically and radiographically followed up for >2 years after PCS. The preoperative location and postoperative healing of the lunate fracture were evaluated using plain radiography, computed tomography, and/or magnetic resonance imaging. Results were evaluated using the Kienböck scoring system by Nakamura. PCS was clinically effective, demonstrating excellent and good results in 11 and 11 patients, respectively. Pain evaluated using the visual analog scale, wrist extension, flexion motion, and grip strength significantly improved postoperatively (p < 0.01). Fractures were preoperatively detected in all 23 cases. Fracture locations were preoperatively classified into five subtypes based on radiographs: volar pole in five patients, dorsal pole in three, coronal in five, transverse in nine, and ulnar in one. The overall union rate of the lunate fracture was 48%, whereas none of the coronal fractures healed. PCS was effective in treating stage 3 Kienböck disease. Coronal lunate fractures had a poor healing rate relative to those of the other fracture types. Clinical, retrospective study.
Sections du résumé
BACKGROUND
BACKGROUND
It is unclear whether lunate fracture types in Kienböck disease correlate with the degree of fracture healing. This study aimed to review the clinical results of stage 3 Kienböck disease treated using partial capitate shortening (PCS) and to evaluate the healing rates of lunate fractures based on the fracture types.
METHODS
METHODS
Twenty-three patients were clinically and radiographically followed up for >2 years after PCS. The preoperative location and postoperative healing of the lunate fracture were evaluated using plain radiography, computed tomography, and/or magnetic resonance imaging. Results were evaluated using the Kienböck scoring system by Nakamura.
RESULTS
RESULTS
PCS was clinically effective, demonstrating excellent and good results in 11 and 11 patients, respectively. Pain evaluated using the visual analog scale, wrist extension, flexion motion, and grip strength significantly improved postoperatively (p < 0.01). Fractures were preoperatively detected in all 23 cases. Fracture locations were preoperatively classified into five subtypes based on radiographs: volar pole in five patients, dorsal pole in three, coronal in five, transverse in nine, and ulnar in one. The overall union rate of the lunate fracture was 48%, whereas none of the coronal fractures healed.
CONCLUSIONS
CONCLUSIONS
PCS was effective in treating stage 3 Kienböck disease. Coronal lunate fractures had a poor healing rate relative to those of the other fracture types.
STUDY DESIGN
METHODS
Clinical, retrospective study.
Identifiants
pubmed: 31279495
pii: S0949-2658(19)30182-4
doi: 10.1016/j.jos.2019.06.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
428-434Informations de copyright
Copyright © 2019 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.