Examination of radioulnocarpal joint loading after radial shortening osteotomy for the treatment of Kienböck?s disease (Biomechanical study)

Radial shortening osteotomy is a well known applied technique for unloading radiolunate joint in cases of Kienböck?s disease and negative ulnar variance. Radial shortening osteotomy provides good clinical results in neutral or positive ulnar variances and advanced stage Kienböck?s disease cases. We think another mechanism is effective in radial shortening osteotomy rather than the radiolunate joint unloading. Therefore, in this study we aimed to show the effects of radial shortening osteotomy on the radiolunate joint load distributionIn this biomechanical study, we used standart left wrist models made of solid foam (Sawbones®, Malmö, Sweden). The radioulnocarpal joint load distribution was investigated in normal wrist model and 2mm and 4mm radial shortening osteotomy models under 14kgf and 25kgf loads when the wrist position was neutralIn the normal wrist group, the comparison of the average pressure distributions under the loads of 14kgf and 25kgf shows that the increase at the ulnocarpal joint loading and the decrease at the radiolunate joint loading were statistically significant (p=0,012, p=0,036, respectively). When we compare the respective average pressure distributions after 14kgf and 25 kgf loading, there were no statistically significant difference between the normal wrist and the osteotomy groupsConsequently, radial shortening osteotomy is not effective to decrease the radiolunate joint loading when the wrist is in neutral positionKey words: Kienböck?s disease, radial shortening osteotomy, biomechanics, radioulnocarpal joint loading