Mid to Long-term Outcome of Vascularized Pronator Quadratus-wrapped Radial Bone Flap Arthroplasty for Advanced $Kienb{\ddot{o}}ck's$ Disease

진행된 키엔벡 병에서의 방형회내근 유경 요골 피판을 이용한 관절성형술의 중장기 결과

The purpose of this study was to analyze the mid to long-term clinical and radiological outcome of vascularized pronator quadratus-wrapped radial bone flap arthroplasty for symptomatic advanced $Kienb{\ddot{o}}ck's$ disease. Between 1982 and 2000, 41 cases of advanced $Kienb{\ddot{o}}ck's$ disease were treated with vascularized pronator quadratus wrapped radial bone flap arthroplasty. There were 17 men and 24 women, with a mean age of 39 years at the time of operation. According to Lichtman's classification, there were 13 stage IIIb and 28 stage IV patients. The duration of follow-up averaged 6.1 ($3{\sim}22$) years. We assessed the clinical outcome by subjective pain and active range of motion of the wrist, and evaluated the radiologic outcome by using carpal height ratio and radioscaphoid angle. Postoperatively, all patient reported an improvement in their symptoms. The mean active extension and flexion were improved by $9^{\circ}$ and $6^{\circ}$, respectively (p<0.05). The carpal height ratio was decreased from a mean of 0.52 to 0.48, and the radioscahpoid angle was increased from a mean of $61^{\circ}$ to $66^{\circ}$, but the differences were not significant statistically. Vascularized pronator quadratus-wrapped radial bone flap arthroplasty improves the wrist motion and may prevent serious carpal collapse in advanced $Kienb{\ddot{o}}ck's$ Disease.