Kienböck 병의 치료에서 관절경의 유용성과 한계

Abstract

Kienböck’s disease is an avascular necrosis of the lunate that can be accompanied by a lunate fracture. Although numerous studies on Kienböck’s disease have been conducted, its natural history is incompletely understood and there is no consensus for treatment. Various wrist arthroscopic surgeries have been attempted owing to the increasing interest in wrist minimal-invasive surgery. Traditionally, the Lichtman classification, based on the osseous status, is used widely to assess Kienböck’s disease. On the other hand, age, vascular condition, and cartilage status are also important when making a treatment plan for Kienböck’s disease. This article introduces a new classification and treatment algorithm combining osseous, vascular and cartilage classifications. Moreover, the roles and limitations of arthroscopy in this new algorithm are reviewed, and the author’s preferred treatment protocol based on staging is introduced.