Long - term Follow - up after the Treatment of Kienbock's Disease by Packing of Fascia Lata Flap

Lee, Seung Koo; Huh, Doo Young

Abstract

We found that the packing of a rolled tensor fascia lata flap after the excision of avascular lunate was reasonably effective in relieving symptoms in 4 patients with advanced Kienbock's disease, even though there was still some residual postoperative loss of wrist motion and grip strength, and the slightly progressive tendencies of earpal collapse and translation as well as rotational deformities of scaphoid. Pre-operatively all patients had pain and limited motion of the wrist as well as weakness of grip. Roentgenographically all had sclerosis, fragmentation and collapse of the lunate. They were analysed each two cases in advanced stage II and III according to the classification by Lichtman. Most had symptoms for longer than two and half years. After removal of the avascular lunate through a dorsal incision, a rolled tensor fascia lata flap was packed to fit the defect. Patients were followed for an average of sixteen months. All were improved clinically but there were somewhat postoperative progress in carpal collapse, translation and rotational deformities of scaphoid roentgenographically.