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Radial-Shortening and Ulnar-Lengthening Operations for Kienböck’s Disease

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Kienböck’s Disease

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Abstract

The most common procedures to treat Kienböck’s disease involve osteotomies of the radius or ulna and are frequently referred to as joint-leveling procedures. The theory for these osteotomies, first proposed by Hultén in 1928, comes from the belief that abnormal association between the lunate and radius leads to altered mechanics at the radiocarpal joint which predispose those individuals to developing Kienböck’s disease. Various osteotomies of the radius and ulna can be categorized into three main groups: radial shortening, radial wedge, and ulnar lengthening. New long-term outcome data for radial shortening and wedge osteotomies have been promising despite radiographic progression of disease and have thus widened indications for such procedures. While biomechanical data has lent support to each group, ulnar-lengthening procedures have largely fallen out of favor secondary to increased complication rates relative to other options. Despite these complications, ulnar-lengthening osteotomy along with radial-sided osteotomies offer the added benefit of staying extra-articular should further intra-articular salvage procedures be required in the future.

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Authors and Affiliations

  1. Department of Orthopedics, Davis Health Care System, University of California, 4860 Y Street, Suite 3800, Sacramento, CA, 95817, USA

    Anuj P. Netto MD, MPH & Robert M. Szabo MD, MPH

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  1. Anuj P. Netto MD, MPH
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  2. Robert M. Szabo MD, MPH
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Correspondence to Robert M. Szabo MD, MPH .

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Editors and Affiliations

  1. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

    David M. Lichtman

  2. Department of Orthopedic Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia

    Gregory Ian Bain

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Netto, A.P., Szabo, R.M. (2016). Radial-Shortening and Ulnar-Lengthening Operations for Kienböck’s Disease. In: Lichtman, D., Bain, G. (eds) Kienböck’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-34226-9_16

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  • DOI: https://doi.org/10.1007/978-3-319-34226-9_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34224-5

  • Online ISBN: 978-3-319-34226-9

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