• Journal of the Korean Orthopaedic Association
• /
• v.56 no.6
• /
• pp.461-471
• /
• 2021

Kienböck's disease is known as avascular necrosis of the lunar bone, but its natural course or optimal treatment in various stages has not been identified clearly. The textbook divides the progression of the disease and suggests treatment methods according to the stages, but it is unclear if conforming to the principle without sufficient verification is the correct treatment method. While diagnosing and treating many Kienböck's diseases, the author has had many questions regarding the treatment choices described in the textbook and tried to establish an optimal treatment based on data evidence and experience. This review presents the most appropriate and reasonable treatment method while questioning whether the previous knowledge is based on an accurate basis.

• Journal of Acupuncture Research
• /
• v.30 no.5
• /
• pp.203-209
• /
• 2013

Objectives : The purpose of this study is to report the clinical effects of Korean medical treatment for Kienb$\ddot{o}$ck's disease. Methods : The patient was treated using acupuncture, electroacupuncture, herbal medicine, pharmacopuncture treatment, and other treatments including moxibustion, physical rehabilitation for 6 weeks. And we evaluated the patient through verbal rating scale(VRS), disability of the arm, shoulder and hand(DASH), range of motion(ROM). Results : After treatment, VRS is changed from 7 to 3, DASH is changed from 37.93 to 20.69. And ROM is changed from $60^{\circ}$ to $70^{\circ}$ in wrist flexion, and from $10^{\circ}$ to $15^{\circ}$ in radial deviation. Conclusion : These results suggest that Korean medical treatment is effective to the patient complaining pain and dysfunction.

• Archives of Reconstructive Microsurgery
• /
• v.15 no.2
• /
• pp.101-106
• /
• 2006

The purpose of this study was to analyze the mid to long-term clinical and radiological outcome of vascularized pronator quadratus-wrapped radial bone flap arthroplasty for symptomatic advanced $Kienb{\ddot{o}}ck's$ disease. Between 1982 and 2000, 41 cases of advanced $Kienb{\ddot{o}}ck's$ disease were treated with vascularized pronator quadratus wrapped radial bone flap arthroplasty. There were 17 men and 24 women, with a mean age of 39 years at the time of operation. According to Lichtman's classification, there were 13 stage IIIb and 28 stage IV patients. The duration of follow-up averaged 6.1 ($3{\sim}22$) years. We assessed the clinical outcome by subjective pain and active range of motion of the wrist, and evaluated the radiologic outcome by using carpal height ratio and radioscaphoid angle. Postoperatively, all patient reported an improvement in their symptoms. The mean active extension and flexion were improved by $9^{\circ}$ and $6^{\circ}$, respectively (p<0.05). The carpal height ratio was decreased from a mean of 0.52 to 0.48, and the radioscahpoid angle was increased from a mean of $61^{\circ}$ to $66^{\circ}$, but the differences were not significant statistically. Vascularized pronator quadratus-wrapped radial bone flap arthroplasty improves the wrist motion and may prevent serious carpal collapse in advanced $Kienb{\ddot{o}}ck's$ Disease.

• Archives of Reconstructive Microsurgery
• /
• v.17 no.2
• /
• pp.108-114
• /
• 2008

Purpose: There are many controversies concerning therapeutic guidelines for the treatment of Kienb$\ddot{o}$ck's disease. The purpose of this study is to evaluate the clinical and radiological result of lunate replacement by vascularized os pisiform transfer in advanced Kienb$\ddot{o}$ck's disease. Materials & Methods: There were two men and three women. The mean age was 55 years, ranging from 41 to 70. According to Lichtman's classification, three cases were stage IIIb and two cases were stage IV. Results: At the period of follow up, pain during motion was markedly diminished in all patients, the arc of motion ranged on average from 49 degrees of flexion to 53 degrees of extension and the grip power of the affected hand reached on average 83% compared with the contralateral side. Clinical results assessed by DASH and modified Mayo score showed 8 and 90. On plain X-rays, carpal height ratio and radioscaphoid angle were not changed postoperatively. Conclusion: Lunate excision and vascularized os pisiform transfer is a reliable alternative method for the treatment of advanced Kienb$\ddot{o}$ck's disease.