Acta Ortopédica Mexicana

Puig-Zentella M, Rivas-Montero JA, Hernández-Méndez-Villamil E, Espinosa-Gutiérrez AJ
Intercarpal fusion as a salvage procedure in Kienböck disease
Acta Ortop Mex 2016; 30 (6)

Language: Español
References: 5
Page: 296-301
PDF: 220.14 Kb.

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Introduction: Functional results of four surgical techniques to resolve the IIIB-IV Litchman's stage of the Kienböck disease were analyzed. We observed the evolution from 2000 to 2015. Material and methods: Transversal retrospective study of 33 patients treated with different surgical techniques and evaluated with Quick-DASH scale, dynamometer and EVA. Results: Less functional limitation was found in the patients who underwent the intercarpal fusion with or without neurotomy of the posterior interosseous. Discussion: It was shown that the fact of making a less aggressive surgery is enough to evolve into an increase in symptoms and a decrease in function and strength; therefore, the intercarpal fusion performed at the right time of the natural history of the disease can achieve better results than other methods used previously and endorsed by international associations.
Conclusions: The surgical technique of choice in our series to prevent disease progression was the intercarpal fusion and neurotomy of the posterior interosseous nerve.

Key words: Kienböck disease, Lichtman’s classification, intercarpal arthrodesis.