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Radial Overgrowth After Radial Shortening Osteotomies for Skeletally Immature Patients With Kienböck's Disease

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Title: Radial Overgrowth After Radial Shortening Osteotomies for Skeletally Immature Patients With Kienböck's Disease
Authors: Matsuhashi, Tomoya Browse this author
Iwasaki, Norimasa Browse this author →KAKEN DB
Oizumi, Naomi Browse this author
Kato, Hiroyuki Browse this author
Minami, Michio Browse this author
Minami, Akio Browse this author →KAKEN DB
Keywords: Kienböck's disease
Radial shortening
Radial shortening osteotomy
skeletally immature patients
postoperative overgrowth
Issue Date: Sep-2009
Publisher: Elsevier Inc.
Journal Title: The Journal of Hand Surgery
Volume: 34
Issue: 7
Start Page: 1242
End Page: 1247
Publisher DOI: 10.1016/j.jhsa.2009.04.028
PMID: 19700072
Abstract: Purpose: We hypothesized that radial shortening osteotomy (radial shortening) for skeletally immature patients with Kienböck's disease would induce overgrowth of the radius. The purpose of this study was to determine the effect of radial shortening on radial growth in skeletally immature patients with Kienböck's disease and to clarify the relationship between the postoperative growth alterations and the clinical results. Methods: Eight wrists of 8 skeletally immature patients with Kienböck's disease were treated with radial shortening. There were 3 males and 5 females, ranging in age from 11 to 18 (mean, 14) years old. All patients presented with open physis and negative ulnar variance. The length of the radial shortening equaled the amount of negative ulnar variance. Clinical assessment was based on the modified Nakamura scoring system. Radiographic assessment, including Lichtman's stages, ulnar variance, carpal height ratio, radial inclination, and volar tilt, was performed preoperation, immediately after surgery, and at follow-up. A difference in ulnar variance of more than 2 mm between these time points was considered to be overgrowth. Statistical comparisons were performed using paired t-tests. Results: At a mean follow-up period of 69 months, the mean clinical score was 19.7 of 21 maximum points, with all wrists rated as excellent. Radiographically, no progression of Lichtman stage was found in any patient. At follow-up, the X-ray and MRI findings indicated lunate revascularization in all patients. Four of the 8 were recognized to have had overgrowth in the operated radius. On the other hand, other radiographic parameters showed no significant changes at follow-up. The occurrence of postoperative radial overgrowth did not significantly affect the clinical scores. Conclusions: The current results suggest the probability of occurrence in the overgrowth of the radius in skeletally immature patients with Kienböck's disease treated with radial shortening. The postoperative radial overgrowth after this osteotomy had no effects on clinical and other radiographic outcomes.
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 岩崎 倫政

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