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Of 32 patients with Kienböck's disease, 19 had lunate silicone implant replacements,
and 13 had coiled palmaris longus tendon replacement. The carpal height was measured
and osteoarthritic changes were noted in plain x-ray films before and after the operation.
Follow-up periods ranged from 3 to 11 years, with an average of 6 years 4 months.
In patients in the mild stages of the preoperative carpal collapse, both excisional
arthroplasties had good clinical results. The x-ray films showed that a silicone implant
played a more important role in preventing further carpal collapse than a palmaris
longus tendon replacement in patients in the early carpal collapse stage. However,
the clinical results of the silicone implant replacement were unsatisfactory because
of the postoperative progression of osteoarthritic changes or subluxation of the prosthesis
in the advanced stages of carpal collapse. The palmaris longus tendon replacement
gave satisfactory results in four of seven patients with advanced carpal collapse.
These results suggest that silicone implant replacement is indicated primarily in
patients with the early stages of carpal collapse, and replacement of the palmaris
longus tendon is rarely recommended in either the early or late stages of carpal collapse.
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Article info
Publication history
Accepted:
January 3,
1986
Received:
April 30,
1985
Footnotes
+Presented at the Fortieth Annual Meeting of the American Society for Surgery of the Hand, Las Vegas, Nevada, Jan., 1985.
Identification
Copyright
© 1986 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
