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Stage IV Kienböck's disease: Proximal row carpectomy and application of RCPI implant
- Source :
- Hand surgeryrehabilitation. 36(2)
- Publication Year :
- 2015
-
Abstract
- Kienbock disease is an aseptic osteonecrosis of the lunate, which gradually leads to total carpal collapse. Lichtman's classification relates radiographic evidence of wrist damage to four different stages and supports surgical decision-making. This study pertains to six patients (2 males and 4 females) affected by stage IV Kienbock's disease who underwent proximal row carpectomy and received an RCPI implant. The clinical outcomes consisted of wrist range of motion (ROM), pain on a VAS scale (0–10), the DASH score and the patient's level of satisfaction. The mean follow-up was 27.6 months (16–36). Pain relief and improvements in wrist flexion – extension ROM, radial – ulnar deviation and strength were achieved in every patient. There were no cases of implant failure or dislocation. Considering the good results obtained, we believe that proximal row carpectomy associated with the use of a pyrocarbon RCPI implant is a valid surgical technique for the treatment of stage IV Kienbock's disease. It is a good alternative to carpal fusion, which leads to wrist immobility, and to total wrist joint replacement, which has a high incidence of dislocation and fracture.
- Subjects :
- musculoskeletal diseases
Adult
Male
Wrist Joint
medicine.medical_specialty
Visual Analog Scale
Radiography
030230 surgery
Wrist
03 medical and health sciences
Disability Evaluation
0302 clinical medicine
Return to Work
medicine
Humans
Orthopedics and Sports Medicine
Range of Motion, Articular
Carpal Bones
Aged
Retrospective Studies
030222 orthopedics
Hand Strength
business.industry
Rehabilitation
Osteonecrosis
Implant failure
Prostheses and Implants
Middle Aged
medicine.disease
Carbon
Surgery
body regions
Lunate
medicine.anatomical_structure
Patient Satisfaction
Ulnar deviation
Female
Kienböck's disease
Implant
business
Range of motion
Follow-Up Studies
Subjects
Details
- ISSN :
- 24681210
- Volume :
- 36
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Hand surgeryrehabilitation
- Accession number :
- edsair.doi.dedup.....7cdff7430878be26aeaddeca3cb92b35