versão On-line ISSN 2309-8309
versão impressa ISSN 1681-150X
SA orthop. j. vol.7 no.3 Pretoria Jul./Set. 2008
H SithebeI; U MennenII
IMBChB (Medunsa). Department of Hand and Microsurgery, University of Limpopo MEDUNSA Campus & Dr George Mukhari Hospital
IIMBChB; FRCS(Glasgow et Edinburgh); FCS(SA)(Orth); MMed(Orth); MD(Orth); DSc(Med). Department of Hand and Microsurgery, University of Limpopo MEDUNSA Campus & Dr George Mukhari Hospital
The aim of the study was to determine the incidence of asymptomatic Kienböck's disease in patients who attended the Dr George Mukhari Hospital (formerly: Ga-Rankuwa Hospital), and to determine the relevance of ulnar variance on the disease.
This was a retrospective study. In a 12-month period we reviewed postero-anterior X-rays of 1 287 patients seen at our radiology department, with complaints unrelated to the upper limb including the wrist and hand.
We identified 23 cases (1.87%) of asymptomatic Kienböck's disease. The majority (63%) were male with an average age of 49 years, and 37% were female with an average age of 46.5 years. All were unilateral and all were in the dominant hand. Thirteen cases (57%) had an ulna neutral wrist and the remaining ten (43%) had an ulnar negative variance. The vast majority (83%) were unemployed.
From the results of our study we could deduct with reasonable confidence that at least a 1.87% incidence of asymptomatic stage II, III and IV Kienböck's disease is present in the black African population. Analysis of the data shed no further light on the aetiology. The relevance of ulnar variance as an aetiological factor is seriously questioned.
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1. Peste JL. Discussion. Bull Soc Anat Paris 1843;18:164. [ Links ]
2. Kienböck R. 'Traumatische Malazie des Mondbeins und Ihre Folgenstande: Entartungsformen und Kompressionfrakturen' Fortschr Geb Rontgenstr 1910;16:77-103 (translated by Peltier LF in CORR 1980;149-154). [ Links ]
3. Goldsmith R. Kienböck's disease of the semilunar bone. Ann Surg 1925;18:857. [ Links ]
4.Speed K. In: A textbook of fractures and dislocations. Philadelphia: Lea & Febiger 1916:826. [ Links ]
5. Hulten O. Uber Anatomische Variationen der Handgelenknochen. Ein Beitrag zur Kenntnis der Genese bei verschiedener Mondbeinveranderungen. Acta Radiol 1928;9:155-68. [ Links ]
6. Kostler J. Randstandige Mondbeinsschadigungen. Z Orthop 1944;75:11. [ Links ]
7. Gelberman RH, Salamon PB, Jurist JM, Posch JL. Ulnar variance in Kienböck's disease. J Bone Joint Surg (Am) 1975;57:674. [ Links ]
8. Lee MLH. The intraosseous arterial pattern of the carpal lunate and its relation to avascular necrosis. Acta Orth Scand 1963;33:43-55. [ Links ]
9. Gelberman RH, Bauman TD, Menon J. The Vascularity of the Lunate and Kienböck's Disease. J Hand Surg(A) May 1980;5(3):272-8. [ Links ]
10. Taniguchi Y, Tamaki T, Nakatan N. Long-term results of non-surgical treatment of Kienböck's disease. J Jpn Soc Surg Hand 1993;9:962. [ Links ]
11. Nakamura R, Tsuge S, Watanabe K, et al. Kienböck's disease and ulnar variance. In: Nakamura R, Linscheid RL, Miura T (eds): Wrist Disorders: Current Concepts and Challenges. Tokyo, Springer-Verlag 1992:89-93. [ Links ]
Prof U Mennen
374 Lawley Street
Waterkloof, 0181 Pretoria
Fax: (012) 346-6968
This article was submitted to an ethical committee for approval. The content of this article is the sole work of the authors.
No benefits of any form have been derived from any commercial party related directly or indirectly to the subject of this article.