Treatment of Kienbock Disease with Radial Shortening: A Mid-Term Follow-Up

Kienbock disease resulting from avascular necrosis of lunate bone leads to pain and disability in young active patients. Radial shortening is one of the treatment methods in this disease. In this study we evaluated the mid-term results of treatment of Kienbock using radial shortening. In a retrospective study 9 males and 6 females with Kienbock disease with average age of 28.6±9.37 years who had undergone radial shortening were examined in a teaching hospital in Tehran-Iran. There were 2 patients in stage II 5 in IIIa and 8 in step IIIb of Lichman’s class. In a mean follow-up of 5±2.44 years these 15 cases were evaluated for wrist motion and gap strength and also with quick-DASH score. The radiograph Stahl index and carpal height ratio were also assessed. Pain and range of motion improved and grip strength was favorable in 13 patients. Quick-DASH score was 8.5±.84 in patients with stage II 12.72±5.09 in stage IIIa and 27.57±18.87 in stage IIIb. Stahl index and carpal height ratio were the same in patients with stage II but significantly decreased in other patients. Kienbock disease progressed in 2 cases. Radial shortening can relief clinical symptoms even in stage III and IIIb of Kienback diseases although the disease X-ray show radiographic worsening.