Radiological Investigation of Relationship Between Lunate type and Ulnar Variance
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Some variances and anatomical proportions of the wrist may contribute to development of avascular necrosis of the lunate. Kienböck’s disease is more often encountered in young males, who suffer, among others, from type II of the lunate (with two joint surfaces for the capitate and hamate) and/or negative variance of ulna in relation to radius. The aim of the study was to investigate whether there exists interdependence between the simultaneous occurrence of individual types of the lunate with one of the variances of ulna in both genders. Material and methods. A retrospective analysis of 394 (n=394) radiological tests of the wrist in 174 (44%) women and 220 (56%) males aged 18-83 years (average age 39 years). From the entire pool, 265 X-rays were educed in 104 females and 161 males, and no fractures or wrist instability features were could be observed. The X-rays were obtained from computer lab and archive data base at St Hedwig Hospital in Trzebnica from the beginning of January 2011 to the end of December 2012. Results. 196 cases (74%) were found with type I of the lunate and 69 cases (26%) with type II. Ulnar variance amounted to from +4.7 mm to -4.2 mm (mean value +0.9 mm). Positive ulnar variance was stated in 44 patients (16.6%), negative in 63 (23.7%) and neutral accounted for the biggest group of other 158 (59.7%) patients. Conclusions. Neutral variance of ulna is the one that occurs most often in the Polish population. There is no correlation between gender and ulnar variance. There is also lack of direct connection between occurrence of individual lunate types and ulnar variance.
1 - 10 - 2013
01 - 12 - 2013
- 1. Thienpont E, Mulier T, Rega F et al.: Radiographic analysis of anatomical risk factors for Kienböck’s disease. Acta Orthop Belg 2004; 70(5): 406-09.
- 2. Schuind F, Eslami S, Ledoux P: Kienböck’s disease. J Bone Joint Surg Br 2008; 90(2): 133-39.[Crossref][PubMed]
- 3. Dubey PP, Chauhan NK , Siddiqui MS et al.: Study of vascular supply of lunate and consider ation applied to Kienböck disease. Hand Surg 2011; 16(1): 9-13.[Crossref]
- 4. Tomaino MM: Ulnar impaction syndrome in the ulnar negative and neutral wrist. Diagnosis and pathoanatomy. J Hand Surg (Br) 1998; 23: 754-57.
- 5. Kienbock R: Uber traumatische Malazie des Monatbeins und ihre Folgezustande: Entartungsfomen und Kompressionsfrakturen Fortschrit Rontgenstrallen 1910; 16: 77.
- 6. Jensen CH: Interosseous pressure in Kienbock’s disease, J Hand Surg 1993; 18A: 355-59.[Crossref]
- 7. Lutsky K, Beredjiklian PK: Kienböck disease. JHand Surg Am 2012; 37(9): 1942-52.[Crossref]
- 8. Luch A, Garcia-Elias M: Etiology of Kienböck disease. Tech Hand Up Extrem Surg 2011; 15(1): 33-37.
- 9. Ledoux P, Lamblin D, Wuilbaut A et al.: A finiteelement analysis of Kienböck’s disease. J HandSurg Eur 2008; 33(3): 286-91.
- 10. Gelberman RH, Taleisnik J, Panagis JS et al.: The arterial anatomy of the human carpus: I. the extraosseous vascularity. J Hand Surg Am 1983; 8: 367-75.[Crossref]
- 11. Saunders BM, Lichtman D: A classificationbased treatment algorithm for Kienböck’s disease: current and future considerations. Tech Hand UpExtrem Surg 2011; 15(1): 38-40.[Crossref]
- 12. Afshar A, Eivaziatashbeik K: Long-term clinical and radiological outcomes of radial shortening osteotomy and vascularized bone graft in kienböck disease. Hand Surg Am 2013; 38(2): 289-96.[Crossref][WoS]
- 13. Blanco RH, Blanco FR: Osteotomy of the radius without shortening for Kienböck’s disease: a 10-year follow-up. J Hand Surg Am 2012; 37(11): 2221-25.[Crossref][WoS]
- 14. Chan K., Huang P: Anatomical variations in radial lenghths in the wrists of chinese. Clin Orthop 1971; 80: 17-20.[Crossref]
- 15. Gelberman R, Salamon P, Jurist J et al.: Ulnar variance in Kienböck’s disease. J Bone Joint Surg 1975; 57-A: 674-76.
- 16. Kristensen S, Thomassen E, Christensen F: Ulnar variance and Kienbock’s disease. J HandSurg 1986; 11-B: 255-60.
- 17. Czitrom A, Dobyns J, Linscheid R: Ulnar variance in carpal instability. J Hand Surg 1987; 12-A: 205-12.[Crossref]
- 18. Mandelbaum B, Bortolozzi A, Dary C et al.: Wrist pain syndrome in gymnast. Am J Sports Med 1989; 17: 305-17.[Crossref]
- 19. Nakamura R, Tanaka Y, Umaeda T et al.: The influence of age and sex on ulnar variance. J HandSurg 1991; 16-B: 84-88.
- 20. Afshar A, Aminzadeh-Gohari A, Yekta Z: The association of Kienböck’s disease and ulnar variance in the Iranian population. J Hand Surg Eur 2013; 38(5): 496-99.[Crossref]
- 21. Hulten O: Uber anatomische variation der handgelenkknochen. Acta Radiol 1928; 9: 155-69.[Crossref]
- 22. Sundberg S, Linscheid R: Kienböck’s disease: results of treatment with ulnar lengthening. CilnOrthop 1984; 187: 43-51.
- 23. Nathan P, Meadowq K: Ulnar-minus variance and Kienböck’s disease. J Hand Surg 1987; 12-A: 77-79.
- 24. Wun-Schen C, Marotta J, Powell J: Ulnar variance and Kienböck’s disease. Clin Orthop 1990; 225: 124-27.
- 25. Kataoka T, Moritomo H, Omokawa S et al.: Ulnar variance: its relationship to ulnar foveal morphology and forearm kinematics. J Hand SurgAm 2012; 37(4): 729-35. doi: 10.1016/j.jhsa. 2012.01.033. Epub 2012 Mar 8.[Crossref]
- 26. Laino DK, Petchprapa CN , Lee SK : Ulnar variance: correlation of plain radiographs, computed tomography, and magnetic resonance imaging with anatomic dissection. J Hand Surg Am 2012; 37(1): 90-97.[PubMed][Crossref][WoS]
- 27. Schuurman AH, Maas M, Dijkstra PF, KauerJM: Ulnar variance and the shape of the lunate bone. A radiological investigation. Acta Orthop Belg 2001; 67(5): 464-67. [PubMed]
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