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Corresponding Author

Ahmed Mohamed Zaki

Document Type

Original Article

Abstract

Background: Avascular necrosis of the lunate, known as Kienbock's Disease, manifests as progressive wrist discomfort and atypical carpal motion. Kienbock disease possesses the capacity to result in significant wrist degeneration and impaired wrist function ultimately. Management of Kienböck's disease depends on the radiological stage of the disease.

Aim and objectives: To assess the wrist arthroscopically in cases with Kienbock disease and compare the imaging and wrist arthroscopy findings in grading Kienbock's disease and in making the management decision.

Patients and methods: This prospective study was conducted on ten cases of Kienbock's disease at Al-Azhar University Hospitals. Aiming to correlate radiographic stages and arthroscopic findings and determine whether this changes the surgical decision.

Results: The classification of the disease can be changed according to the findings of imaging and arthroscopy. The classification based on x-ray changed after CT in 50% of the patients and after MRI in 30%. The classification based on imaging changed after arthroscopic assessment in only one patient. Management decisions changed in 30% of the patients after arthroscopic assessment.

conclusion: Arthroscopic assessment is an effective method for staging wrist articular surface in Kienbock disease and in confirming the radiological classification of the disease also has a vital role in deciding the best way of management.

Keywords

Kienbock's disease; Kienbock grading; Kienbock management; Arthroscopic assessment; Radiological assessment

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