Scaphoid-capitate-hamate-triquetrum Fusion in the Advanced Kienbock's Disease
Journal of the Korean Society for Surgery of the Hand
;
: 120-125, 2009.
Article
in Korean
| WPRIM
| ID: wpr-35642
ABSTRACT
PURPOSE:
To evaluate clinical and radiological results of SCHT(scapho-capito-hamato-triquetral) fusion in Lichtman stage IIIB or IV Kienbock's disease. MATERIALS ANDMETHODS:
The result of eight cases, operated and followed since December 2002, were analyzed retrospectively. The indication of SCHT fusion was the advanced Kienbock's disease, in Lichtman stage IIIB or IV, with severe fragmentation of lunate. The fragmented lunate was excised and the intercarpal joint between scaphoid and capitate, capitate and hamate, hamate and triquetrum were fused with joint resection, bone graft and multiple K-wires, to make an horse-shoeshaped carpal bone block. The clinical results were evaluated by wrist pain, ROM, any radiologic changes of wrist at last follow-up and Kuschner's method.RESULTS:
There were 3 cases of Stage IIIB and 5 cases of stage IV. Mean follow-up period was 28.9 (range 15-53) months, and mean age at the time of operation was 49.4 (range 33~66) years. Two cases were minus ulnar variance, 4 cases were positive and 2 cases were neutral. The wrist range of motion was decreased from 121.8degreesto 90.6degrees(25%). Carpal height ratio was decreased in 1 case. The last follow-up results according to Kuschner's method revealed 4 excellent, 3 good and 1 fair.CONCLUSIONS:
SCHT fustion was considered as one of the favorable salvage procedure for the advanced Kienbock's disease. However, biomechanical study using cadaver, long-term follow-up & accumulation of more cases would be needed to confirm its definitive usefulness in the future.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Osteonecrosis
/
Wrist
/
Cadaver
/
Carpal Bones
/
Retrospective Studies
/
Follow-Up Studies
/
Range of Motion, Articular
/
Transplants
/
Carpal Joints
/
Joints
Type of study:
Observational study
/
Prognostic study
Language:
Korean
Journal:
Journal of the Korean Society for Surgery of the Hand
Year:
2009
Type:
Article
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