Document Detail


Radial overgrowth after radial shortening osteotomies for skeletally immature patients with Kienb??ck's disease.
MedLine Citation:
PMID:  19700072     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We hypothesized that radial shortening osteotomy (radial shortening) for skeletally immature patients with Kienb??ck'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 Kienb??ck'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 Kienb??ck's disease were treated with radial shortening. There were 3 boys and 5 girls, 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 before surgery, immediately after surgery, and at follow-up. A difference in ulnar variance of more than 2 mm between these 3 measurements 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 magnetic resonance imaging findings indicated lunate revascularization in all patients. Four of the 8 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 notably affect the clinical scores. CONCLUSIONS: The current results suggest the probability of overgrowth of the radius in skeletally immature patients with Kienb??ck's disease treated with radial shortening. The postoperative radial overgrowth after this osteotomy had no effect on clinical and other radiographic outcomes. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Authors:
Tomoya Matsuhashi; Norimasa Iwasaki; Naomi Oizumi; Hiroyuki Kato; Michio Minami; Akio Minami
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  34     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-24     Completed Date:  2010-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1242-7     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Bone Development / physiology
Carpal Bones / growth & development,  radiography
Child
Dysostoses / epidemiology*,  physiopathology,  radiography
Female
Humans
Male
Osteonecrosis / physiopathology,  radiography,  surgery*
Osteotomy* / adverse effects
Radius / growth & development,  radiography,  surgery*
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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