Biomedical subjects

D E Quenzer

Publications and source records attributed to D E Quenzer.

4 recordsLinked to original sources

PubMed1997

Radial recession osteotomy for Kienböck's disease.

Sixty-eight patients underwent radial recession osteotomy for avascular necrosis of the lunate were retrospectively evaluated after an average follow-up period of 52 months. Twenty-five patients had undergone 1 or more additional procedures concurrently for treatment of Kienböck's disease. Pain diminished in 93% of patients, grip strength improved, and wrist motion was preserved; 75% of patients continued in their original occupations, including heavy labor. Surgical complications were uncommon. Four patients subsequently underwent salvage procedures, including 2 total wrist arthrodeses. Three of these 4 patients were receiving workers' compensation. One third of patients demonstrated lunate healing after joint leveling. Preliminary results suggest that concomitant lunate revascularization or vascularized bone grafting may improve the radiographic result. With rare exceptions, radial recession osteotomy relieves pain and improves function in Kienböck's disease.

Adolescent↗

PubMed1997

Trispiral tomographic staging of Kienböck's disease.

Trispiral tomography enhances the staging of Kienböck's disease and aids in surgical planning. The clinical records, plain x-rays, and trispiral tomograms of 105 patients with Kienböck's disease were reviewed. When tomograms were used, upward revision of the classification stage was indicated in 73% of patients with stage I or stage II disease and in 10% of those with stage III disease. On tomograms, 91% of patients had lunate fractures, compared with 55% on plain films. The most common lunate fracture seen on trispiral tomograms was a transverse shear fracture that represented lunate collapse; the next most common was a midcoronal fracture that may be displaced, causing fragment extrusion palmarly or dorsally. The most common instability pattern was nondissociative proximal row flexion, seen in stage III. Indices of carpal collapse and ulnar translation may be useful in following up patients, but values vary widely among patients.

Adolescent↗

PubMed1996

Ulnar lengthening and radial recession procedures for Kienböck's disease. Long-term clinical and radiographic follow-up.

Twenty patients with Kienböck's disease who had undergone a joint levelling procedure, were reviewed at a mean of 11 years following surgery. Clinical and radiological evaluation revealed good long-term results with all patients complaining of less pain than before surgery and with statistically significant increases in range of motion and grip strength. Radiologically a significant number of patients were found still to have lunate fractures and fragmentation. In addition, 13 patients have developed new bone formation in the lunate fossa, and 12 show osteoarthritic changes, particularly at the radioscaphoid interface. Radial shortening was felt to be superior to ulnar lengthening in that there were fewer problems with bone union.

Adult↗

PubMed1993

Ulnar lengthening procedures.

Ulnar lengthening redistributes axial compressive forces partially relieving those on the lunate, slowing or halting further progressive collapse. Long-term results are satisfactory, although restitution of the carpal anatomy is not obtained.

Adolescent↗