[Results of diaphyseal shortening of the radius in the treatment of Kienböck's disease: a series of 31 cases].
PURPOSE OF THE STUDY: Several therapeutic options have been proposed for the treatment of Kienbock's disease, including shortening of the radius. We report results in a series of 31 cases treated by diaphyseal radial shortening with a mean 6-year follow-up (range 1 - 18 years). MATERIAL AND METHODS: The series included 19 women and 12 men, mean age, 26 years (range 17 - 47 years). According to the Lichtmann classification there were 7 grade II, 23 grade IIIa and 1 grade IIIb. Mean shortening was 4.5 mm, ranging from 3 to 6 mm. Pain, mobility, muscle force and radiological presentation were assessed. RESULTS: Pain relief was achieved in all patients; 20 patients were entirely pain free and 11 had exceptional minor pain at exertion. Mean gain in mobility was 22 p. 100 both for palmar flexion and for dorsal flexion. Muscle force was improved in 30 cases with normal force in 18 and slightly less than normal force in 12. Muscle force remained insufficient in one case. According to the Michon criteria, there were 80 p. 100 excellent and good results. The radiographic assessment showed 14 improvements, 16 stabilizations, and 1 aggravation. Overall clinical ouctcome was independent of age, and preoperative radiographic aspect and length of the ulna. In addition, there was no correlation betwen radiological changes of the lunatum and the clinical result. CONCLUSION: Osteotomy for diaphyseal shortenig of the radius is a reliable simple procedure which does not require supplementary immobilization and which avoids complications encountered with self-compressive paltes.