Ulnar lengthening for kienbock disease using ring external fixator [Ilizarov]

ABSTRACT

An ulnar lengthening, using ring external fixator [Ilizarov], was performed in nine pateints who had Kienbock disease. Stages I and IV were excluded from this study. Four pateints [44%] had a history of trauma and all nine wrists had a negative ulnar varience [average 3 mm.] on radiographs. All Wrists were re-examined after an average follow up of 18 months. At that time, the pain had decreased in 89% of the wrists. Extension of the wrists had improved on average of 32%; flexion, 27%; radial deviation, 30%; and ulnar deviation, 40%. The grip strength had improved about 50%. Radiographic evaluation showed improvement in shape of lunate in 44%, and stabilization in 56%. The results were excellent and good in 89% of pateints. Ulnar lengthening is an effective treatment for kienbok disease in wrists that do not have degenerative changes in adjacent carpal joints. Pain, range of motion, and grip strength can be expected to improve