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Category: Volume 07 Issue 12 December 2019
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Title: Radial Inclination and Palmar tilt as Risk Factors for Kienböck’s Disease

Authors: Ajaz Ahmad Bhat, Zubair Ringshawl, Suhail Wani

 DOI: https://dx.doi.org/10.18535/jmscr/v7i12.116

Abstract

Radial inclination angle (RIA) and palmar tilt (PT) of distal articular surface of radius, are anatomical factors that influence force transmission across the wrist and load transfer to the lunate. The purpose of this study is to evaluate the relationship between these parameters and Kienböck’s disease.

We measured and compared RIA and PT in standard posteroanterior and lateral wrist x-rays of 50 patients with Kienböck’s disease and 55 controls. The mean RIA was 26.5° in Kienböck’s disease patients and 24.0° in the control group (P =0 .002). The mean PT was 12.5° and 10.4° for patients and controls, respectively (P = 0.005). All of these differences were statistically significant. We concluded that there is an etiological association between higher degrees of RIA and PT with Kienböck’s disease.

References

  1. Kienbock R; Peltier L (trans-ed): Concerning traumatic malacia of the lunate and its consequences: Degeneration and compression fractures [classic reprint].  Clin Orthop 1980;149:4-8.
  2. Hulten O: ber anatomische Variationen der Handgelenkknochen.  Acta Radiol Scand 1928;9:155-168.
  3. D’Hoore K, DeSmet L, Verellen K, Vral J, Fabry G: Negative ulnar variance is not a risk factor for Kienbcks disease. J Hand Surg [Am] 1994;19:229-231.
  4. Nakamura R, Imaeda T, Miura T: Radial shortening for Kienbcks disease: Factors affecting the operative result. J Hand Surg [Br] 1990;15:40-45.
  5. Tsuge S, Nakamura R: Anatomical risk factors for Kienbcks disease.  J Hand Surg [Br] 1993;18:70-75.
  6. Mirabello SC, Rosental DI, Smith RJ. Correlation of clinical and radiographic findings in Kienböck’s disease. J Hand Surg Am. 1987;12(6):1049-1054.
  7. Lamas C, Mir X, Llusà M, Navarro A. Dorsolateral biplane closing radial osteotomy in zero variant cases of Kienböck’s disease. J Hand Surg Am. 2000;25(4):700-709.
  8. Solgaard S. Fuction after distal radius fracture. Acta Orthop Scand. 1988;59(1):39-42.
  9. Watanabe K, Nakamura R, Horii E, Miura T: Biomechanical analysis of radial wedge osteotomy for the treatment of Kienbcks disease.  J Hand Surg [Am] 1993;18:686-690.
  10. Tsumura H, Himeno S, Kojima T, Kido M. Biomechanical analysis of Kienböck’s disease; its cause and treatments. Seikeigeka. 1982;33:1400-1402.
  11. Tsumura H, Himeno S, An KN, Cooney WP, Chao EYS. Biomechanical analysis of Kienböck’s disease. Orthop Trans. 1987;11:327.
  12. Werner FW, Palmer AK. Biomechanical evaluation of operative procedures to treat Kienböck’s disease. Hand Clin. 1993;9(3):431-443.
  13. Kam B, Topper SM, McLoughlin S, Liu Q. Wedge osteotomies of the radius for Kienböck’s disease: a biomechanical analysis. J Hand Surg Am. 2002;27(1):37-42.
  14. Lichtman DM, Mack GR, MacDonald RI, Gunther SF, Wilson JN: Kienbcks disease: The role of silicone replacement arthroplasty.  J Bone Joint Surg Am 1977;59:899-908.
  15. Levis CM, Yang Z, Gilula LA. Validation of the extensor carpi ulnaris groove as a predictor for the recognition of standard posteroanterior radiographs of the wrist. J Hand Surg Am. 2002;27(2):252-257.
  16. Yang Z, Mann FA, Gilula LA, Haerr C, Larsen CF. Scaphopisocapitate alignment: criterion to establish a neutral lateral view of the wrist. Radiology. 1997;205(3):865-869.
  17. Palmer AK, Glisson RR, Werner FW. Ulnar variance determination. J Hand Surg Am. 1982;7(4):376-379.
  18. Mann FA, Wilson AJ. Gilula LA. Radiographic evaluation of the wrist: what does the hand surgeon want to know? Radiology. 1992;184(1):15-24.
  19. Mir X, Liusa M, Arcalis A, Nardi J. Relationship between ulnar inclination of the distal radial joint and Kienböck’s disease. Rev Esp Cir Mano. 1992;19:93-94.
  20. Nakamura R, Tsuge S, Watanabe K, Tsunoda K. Radial wedge osteotomy for Kienböck’s disease. J Bone Joint Surg Am. 1991;73(9):1391-1396.
  21. Soejima O, Lida H, Komine S, Kikuta T, Naito M. Lateral closing wedge osteotomy of the distal radius for advanced stages of Kienböck’s. J Hand Surg Am. 2002;27(1):31-36.
  22. Miura H, Sugioka Y. Radial closing wedge osteotomy for Kienböck’s disease. J Hand Surg Am. 1996;21(6):1029-1034.
  23. Davood Jafari, MD, Hooman Shariatzadeh, MD, Farid Najd Mazhar, MD, Mohammad H. Ghahremani, MD, and Alireza Jalili, MD. Radial  inclination and palmar tilt as risk factors for  Kienböck’s disease. Am J Orthop. 2012;41(11):E145-146.

Corresponding Author

Ajaz Ahmad Bhat

Medical Officer, Department of Health, J&K