Kienbock Disease, a Tertiary Care Experience from the Developing World
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 7
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.
Authors and Affiliations
Yasir Mohib, Pervaiz Hashmi, Muhammad Atif, Haroon Ur Rashid
Keywords
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- EP ID EP572307
- DOI 10.26717/BJSTR.2017.01.000560
- Views 162
- Downloads 0
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