Fisiopatología de la enfermedad de Kienböck / Fisiopathology in Kienböck´s disease

La enfermedad de Kienböck, tiene una etiología multifactorial.Se han visto implicados factores traumáticos talescomo la fractura del semilunar o los microtraumatismosrepetidos. No siempre son evidentes los traumatismos y eneste grupo los factores predisponentes anatómicos, asícomo las enfermedades, tienen mucho que ver. Se postulaúltimamente que existen factores genéticos implicados en eldesarrollo de la enfermedad.Realizamos un estudio de cada uno de los posibles factoresimplicados en el desarrollo de la enfermedad

The aetiology of Kienböck’s disease is multifactorial.Traumas such as fracture of the lunate bone and repeatedmicrotraumas have been implicated as factors.Trauma is not always evident and anatomical predispositionor disease has a lot to do with this group of factors.It has subsequently been postulated that geneticfactors are involved in development of the disease.We carried out a study on each one of the possible factorsinvolved in development of the disease

[Treatment of sections of the long flexor tendon of the thumb using the Rouhier technic. Apropos of 25 cases]. / Traitement des sections du tendon long fléchisseur du pouce par la technique de Rouhier. A propos de 25 cas.

We treated 28 cases of Flexor Pollicis Longus tendon injury by Rouhier's technique between 1989 and 1996 and reviewed 25 cases, with a minimum follow-up of 6 months and maximum of 8 years. Nine patients presented an associated collateral nerve section. We used the International Federation of Hand Surgery Societies (IFSSH) topographic classification. The surgical technique consisted of Flexor Pollicis Longus lengthening and transosseous pull-out in 16 cases and distal suture in 9. The immobilization time ranged from 4 to 7 weeks. The results were evaluated according to Tubiana's classification, with 2 very good, 14 good, 9 fair and no poor results. Flexor Pollicis Longus simple suture in T2 zone may produce suture blockade, tendon shortening and adherences. Suture through the digital canal must be avoided to decrease these complications. In the absence of bone injuries, better functional results can be obtained with Rouhier's technique than with simple suture.