There are different surgical treatment methods due to the stage of Kienböck's disease. In this study, we aimed to report our clinical experience regarding surgical treatment of Kienböck's disease. Thirty-seven patients were operated on in our hospital due to Kienböck's disease. Lichtman classification was used for disease staging. Metaphyseal decompression was applied to early-stage patients and proximal row carpectomy for late-stage. Patients were evaluated in terms of preoperative and postoperative grip strength, flexion-extension range, ulnar-radial deviation range, VAS scoring, DASH scoring, and patient satisfaction. The mean length of follow-up was 44.02 (20-80) months. According to the Lichtman classification, 24 (64.86%) patients were stage 2 before the treatment; one (2.7%) was stage 3A; five (13.51%) were stage 3B; seven (18.91%) were stage 4. Of the 24 patients who underwent metaphyseal decompression, 13 (54.2%) were female and 11 (45.8%) were male. Of the 13 patients who underwent proximal row carpectomy, eight (61.5%) were female and five (38.5%) were male. A statistically significant increase was recorded in all clinical markers in all patients but one underwent metaphyseal decompression. Preoperative and postoperative mean DASH scores were 89.37 and 49.04 (p=0.0001), respectively. There was a decrease in grip strength in patients who underwent proximal row carpectomy, but it was not statistically significant. The increase in ulnar-radial deviation range of motion was not statistically significant. The increase in the extension-flexion range of motion (from preoperative 71.530 to postoperative 850 p=0.008) and VAS (from preoperative 7.84 to postoperative 4.46 p=0.003) and DASH (from preoperative 87.92 to postoperative 55.23 p=0.006) scores were statistically significant. In conclusion, it was determined that the interventions terminate the radiological progression of Kienböck's disease to a large extent. We think that early diagnosis and treatment of Kienböck's disease is important since the clinical results of early-stage interventions are better.
Key words: Kienböck's disease, metaphyseal decompression, proximal row carpectomy
|
