{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:49:42Z","timestamp":1787755782078,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Age is a preoperative prognostic factor for radial closing wedge osteotomy (RCWO) in Kienbock disease. Specifically, for cases classified as Lichtman stage III, clear criteria for selecting RCWO have not been established. We believe that age can provide vital information for determining the appropriate surgical procedure for Kienbock disease. The aim of this study was to investigate RCWO outcomes for Lichtman stage III by examining different age groups from clinical and radiological perspectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Sixteen patients with Lichtman stage III Kienbock disease underwent RCWO. The median age was 59 years, and the median follow-up period was 2.9 years. We determined the age cutoffs for clinical and radiological outcomes using a receiver operating characteristic curve. Subsequently, we conducted intergroup comparisons of postoperative outcomes between the younger and older age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Age cutoffs were established at 52.5 and 30 years for clinical and radiological outcomes, respectively. In the comparative analysis, the younger age group (\u226452 years; n = 7) demonstrated significantly superior clinical results, including improved range of motion and pain relief, higher postoperative Mayo Wrist Score, and lower Disability of the Arm, Shoulder, and Hand scores. From a radiological perspective, the younger age group (\u226430 years; n = 3) experienced segmented lunate bone fragments healing, indicating an improved disease stage compared with the older group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Based on previous literature and our research findings, it is reasonable to conclude that RCWO results in improved clinical outcomes for patients up to their mid-50s and enhanced radiological outcomes for those up to approximately at the age of 30 years. Further studies on these age cutoffs will contribute to refining the surgical selection criteria for RCWO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.24.00066","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T14:03:09Z","timestamp":1730296989000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Radiographic Outcomes in Kienbock Disease Following Radial Closing Wedge Osteotomy"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8713-3716","authenticated-orcid":false,"given":"Takeru","family":"Yokota","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichi","family":"Ejiri","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Iwaki City Medical Center, Iwaki, Japan"},{"name":"Ejiri Orthopedic Surgery Hand Clinic, Iwaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Iwaki City Medical Center, Iwaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narihiro","family":"Toshiki","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan"},{"name":"Department of Orthopedic Surgery, Iwaki City Medical Center, Iwaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Kameda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10]]},"reference":[{"issue":"9","key":"R1-20250310","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.2106\/00004623-199173090-00015","article-title":"Radial wedge osteotomy for Kienb\u00f6ck disease","volume":"73","author":"Nakamura","year":"1991","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"R2-20250310","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/S0363-5023(03)00490-8","article-title":"Surgical outcome of radial osteotomy for Kienb\u00f6ck's disease-minimum 10 years of follow-up","volume":"28","author":"Koh","year":"2003","journal-title":"J Hand Surg Am"},{"issue":"3","key":"R3-20250310","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1142\/S2424835521500405","article-title":"Radial osteotomy for Kienb\u00f6ck disease: clinical and radiological comparison between younger and older patients","volume":"26","author":"Yamamoto","year":"2021","journal-title":"J Hand Surg Asian Pac"},{"key":"R4-20250310","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/01.blo.0000093907.26658.3b","article-title":"Predictors of clinical results of radial osteotomies for Kienb\u00f6ck\u2019s disease","volume":"415","author":"Iwasaki","year":"2003","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"R5-20250310","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1055\/s-0040-1716353","article-title":"Treatment of stages IIIA and IIIB in Kienbock's disease: a systematic review","volume":"9","author":"Wang","year":"2020","journal-title":"J Wrist Surg"},{"issue":"1","key":"R7-20250310","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1055\/s-0036-1593734","article-title":"Kienb\u00f6ck disease: a new algorithm for the 21st century","volume":"6","author":"Lichtman","year":"2017","journal-title":"J Wrist Surg"},{"issue":"4","key":"R8-20250310","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1055\/s-0036-1584546","article-title":"Kienb\u00f6ck disease and arthroscopy: assessment, classification, and treatment","volume":"5","author":"Bain","year":"2016","journal-title":"J Wrist Surg"},{"issue":"7","key":"R9-20250310","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1177\/1753193410374690","article-title":"The classification and treatment of Kienbock's disease: the state of the art and a look at the future","volume":"35","author":"Lichtman","year":"2010","journal-title":"J Hand Surg Eur"},{"key":"R10-20250310","first-page":"435","article-title":"The optimum correcting angle of wedge osteotomy at the distal end of the radius for Kienbock's disease","volume":"1","author":"Tsumura","year":"1984","journal-title":"J Jpn Soc Surg Hand"},{"key":"R11-20250310","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/00003086-198701000-00020","article-title":"Difficult wrist fractures. Perilunate fracture-dislocations of the wrist","volume":"214","author":"Cooney","year":"1987","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"R12-20250310","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1002\/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L","article-title":"Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG)","volume":"29","author":"Hudak","year":"1996","journal-title":"Am J Ind Med"},{"issue":"3","key":"R13-20250310","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/0363-5023(90)90050-2","article-title":"Lunate silicone replacement arthroplasty in Kienb\u00f6ck's disease: a long-term follow-up","volume":"15","author":"Alexander","year":"1990","journal-title":"J Hand Surg Am"},{"issue":"1","key":"R14-20250310","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4097\/kja.21209","article-title":"Receiver operating characteristic curve: overview and practical use for clinicians","volume":"75","author":"Nahm","year":"2022","journal-title":"Korean J Anesthesiol"},{"issue":"1","key":"R15-20250310","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1055\/s-0035-1544225","article-title":"The management of Kienb\u00f6ck disease: a survey of the ASSH membership","volume":"4","author":"Danoff","year":"2015","journal-title":"J Wrist Surg"},{"issue":"4","key":"R16-20250310","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/0363-5023(93)90319-X","article-title":"Biomechanical analysis of radial wedge osteotomy for the treatment of Kienb\u00f6ck's disease","volume":"18","author":"Watanabe","year":"1993","journal-title":"J Hand Surg Am"},{"issue":"2","key":"R17-20250310","doi-asserted-by":"crossref","first-page":"207","DOI":"10.3109\/17453679308994572","article-title":"Radial osteotomy for Kienb\u00f6ck's disease evaluated by magnetic resonance imaging. 24 cases followed for 1-3 years","volume":"64","author":"Nakamura","year":"1993","journal-title":"Acta Orthop Scand"},{"issue":"1","key":"R18-20250310","first-page":"40","article-title":"Radial shortening for Kienb\u00f6ck\u2019s disease: factors affecting the operative result","volume":"15","author":"Nakamura","year":"1990","journal-title":"J Hand Surg Br"},{"issue":"7","key":"R19-20250310","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1177\/1753193413512222","article-title":"Long-term outcome (20 to 33 years) of radial shortening osteotomy for Kienb\u00f6ck's lunatomalacia","volume":"39","author":"Viljakka","year":"2014","journal-title":"J Hand Surg Eur"},{"issue":"2","key":"R20-20250310","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S0720-048X(97)00065-X","article-title":"Imaging and staging of avascular osteonecroses at the wrist and hand","volume":"25","author":"Schmitt","year":"1997","journal-title":"Eur J Radiol"},{"issue":"3","key":"R21-20250310","doi-asserted-by":"crossref","first-page":"355","DOI":"10.4055\/cios.2017.9.3.355","article-title":"Clinical outcome of lateral wedge osteotomy of the radius in advanced stages of Kienb\u00f6ck's disease","volume":"9","author":"Shin","year":"2017","journal-title":"Clin Orthop Surg"},{"issue":"5","key":"R22-20250310","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.hansur.2021.06.005","article-title":"Improvement in lunate perfusion after radial closing-wedge osteotomy in patients with Kienb\u00f6ck's disease","volume":"40","author":"Lee","year":"2021","journal-title":"Hand Surg Rehabil"},{"issue":"1","key":"R23-20250310","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/1558944715616953","article-title":"Current trends in treatment of Kienb\u00f6ck disease: a survey of hand surgeons","volume":"11","author":"Kolovich","year":"2016","journal-title":"Hand (N Y)"},{"issue":"1","key":"R25-20250310","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.main.2014.10.149","article-title":"Kienb\u00f6ck's disease","volume":"34","author":"Fontaine","year":"2015","journal-title":"Chir Main"},{"issue":"5","key":"R26-20250310","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/BF00419936","article-title":"Aged-onset Kienb\u00f6ck's disease","volume":"109","author":"Yoshida","year":"1990","journal-title":"Arch Orthop Trauma Surg"}],"container-title":["JBJS Open Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.24.00066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:52:31Z","timestamp":1787752351000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.24.00066"}},"subtitle":["An Age Comparative Study and Literature Review"],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.oa.24.00066","relation":{},"ISSN":["2472-7245"],"issn-type":[{"value":"2472-7245","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]}}}