Long-term Follow-up of Modified Graner Procedure for Patients with Advanced Kienboeck's Dosease
| Accession number;07A0143197 |
| Title;Long-term Follow-up of Modified Graner Procedure for Patients with Advanced Kienboeck's Dosease |
| Author;TAKASE KATSUMI(Tokyo Medical Univ., JPN) MOROHASHI AKIRA(Tokyo Medical Univ., JPN) MATSUOKA HIROAKI(Tokyo Medical Univ., JPN) YAMAMOTO KENGO(Tokyo Medical Univ., JPN) |
Journal Title;Journal of Japanese Society for Surgery of the Hand
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Journal Code:X0154A
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ISSN:0910-5700
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VOL.23;NO.3;PAGE.252-256(2006)
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| Figure&Table&Reference;FIG.7, REF.8 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Kienboeck's disease is caused by aseptic necrosis of the lunate bone. When the disease becomes advanced, carpal collapse, joint incongruity, and osteoarthritis develop. We performed lunate excision, capitate osteotomy, and intercarpal fusion (modified Graner procedure) on 15 patients with grades 3b and 4 Kienboeck's disease. This report is a review of these patients. The subjects' ages ranged from 26 to 54 years. We evaluated the results more than 10 years postoperatively (range, 125-187 months; mean, 142.7 months). Therapeutic results were evaluated based on Evans' criteria. For most of the patients, the pain disappeared after surgery. For others, the intensity of pain reduced to a mild level. Twelve months after surgery, the grip strength on the affected side had recovered to approximately 80% of the unaffected side. The long-term results for the 15 patients were evaluated as good in 11, fair in 2, and poor in 2. Postoperative radiographs showed that the carpal bone parameters (carpal height index and radioscaphoid angle) had improved. Radiographic osteoarthritic changes were observed in all patients; however, except moderately limiting the range of motion at the wrist joint, these changes did not affect the level of pain, grip strength, or activities of daily living. The modified Graner procedure is a reliable treatment for the patients with advanced Kienboeck's disease for more than ten years postoperatively. (author abst.) |
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