Abstract
Introduction: Kienbock’s disease is a form of osteonecrosis of lunate, first described in 1910 by Robert Kienbock. It occurs most
commonly
in men aged 20 to 40 years of age. Its exact etiology is still under
study but most hand surgeons believe to be a multi-factorial origin and
some
time establishing the diagnosis is a challenge especially in
unaccustomed hands. Management of Kienbock’s disease is focused on
alleviating
pain and halts the worsening disease process [1]. Our study aims to
determine the functional and radiological outcome after surgery for
Kienbock’s disease.
Objective: To determine the functional and radiological outcome after surgery for Kienbock’s disease.
Methods: The retrospective review of patients managed
operatively for Kienbocks disease at Aga Khan University Hospital
Karachi.
Kienbock disease was classified according to Lichtman and Ross
Classification. Patients underwent various procedures including surgical
decompression and vascular bone grafting, etc. Radiological variables
and outcomes were assessed.
Results: Of the 7 patients, 3 (42.9%) were men and 4 (57.1%)
women. The right side was involved in 5(71.4%) patients, and 2(28.6%)
had a left sided Kienbock disease. Duration of symptoms ranges from 8
months to 84 months with mean 31.12 +/- 26.63. Post operative x-rays
6 months follow up which showed Ståhl index minimum 0.29 to maximum 0.45
with mean 0.36 (sd .055), Nattrass index ranges from 0.76 to
1.74 with mean 1.4 (sd 0.31) and Radioscaphoid angle varies from 46.3 to
60.6 with mean 51.7 (sd 5.4).
Conclusion: We concluded that revascularization procedures are effective treatment in stage II and IIIa. Limitation was limited number of
patients which encourage multi-centre trial to prove the efficacy of treatment.
#Kienbock Disease, a Tertiary Care Experience from the Developing World by Yasir Mohib in BJSTR
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