Kienböck’s disease in elderly patients

Abstract Purpose: Kienbock's disease occurs most commonly in the dominant hands of young or middle-aged male manual workers. The aim of this study was to investigate the characteristics of Kienbock's disease in patients older than 60 years of age. Methods: Gender, age at onset, affected side, dominant hand, occupation, and clinical results in 15 wrists of 14 elderly patients with Kienbock's disease were investigated. Age at onset of the disease was defined as the age at first onset of wrist pain. Clinical results were evaluated using the criteria of Dornan. Based on radiographic findings the stage of disease according to Lichtman's classification, ulnar variance, and carpal height ratio were determined. Results: Kienbock's disease in elderly patients occurred in 10 women and 4 men. Fourteen wrists of 13 patients developed the disease when the patients were in their 60s and 1 patient developed the disease in her 70s. It commonly was observed in the dominant hand of manual workers. Negative ulnar variance was present in only 2 wrists. Although radiographic examination revealed development of carpal collapse in all patients, clinical results including surgical and conservative treatment were good or excellent. Conclusions: In elderly patients Kienbock's disease commonly occurred in the dominant hand of manual workers, similar to the conventional characterization of Kienbock's disease. It different, however, from concepts that had been reported previously that Kienbock's disease in elderly patients was found more often in women than in men, and frequency of negative ulnar variance was low. Therefore etiologic factors different from conventional ones might have played a role in our aged patients with Kienbock's disease.