Operative treatment with radial shortening in Kienbock's disease

Eighty-eight patients underwent radial shortening for Kienbock's disease. P rerequisites for surgery were radiographic studies positive for Kienbock's disease without evidence of radiocarpal arthritis and wrist pain unrelieved by conservative management. Thirty-nine patients were evaluated by subject ive questionnaire at a mean postoperative follow-up of 86 months (range: 24 -188 months). Following surgery, a significant decrease was noted in pain s everity, frequency, and duration. Functional status improved postoperativel y, with the most significant gains noted in the following activities: openi ng jars, opening car doors, carrying bags, and shoveling. Only 3 of 34 pati ents employed outside the home were unable to return to their original occu pations due to their wrist problems. Seventy-six patients were evaluated by physical examination at a mean postoperative follow-up of 31 months (range : 3-87 months). Objective evaluation by physical examination revealed a sig nificant improvement in wrist motion and grip strength. Seventy-seven patie nts underwent radiographic evaluation at a mean postoperative follow-up of 31 months (range: 3-180 months). A significant progression in Lichtman stag e of Kienbock's disease was noted despite the favorable subjective findings and high satisfaction ratings. Thirty-six of 39 patients stated they would undergo the surgery again. The long-term data demonstrate radial shortenin g in patients with stage Il-IIIA Kienbock's disease provides substantial im provement over preoperative status.