http://www.medmedia.com/l9/207.htm
Nakamura-R; Tsuge-S; Watanabe-K; Tsunoda-K
Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan.
J-Bone-Joint-Surg-Am. 1991 Oct; 73(9): 1391-6
A radial wedge osteotomy, with reduction of the inclination angle of the distal part of the radius, was performed in twenty-seven patients who had Kienbock disease. After two to five years of follow-up, all of the patients were free of pain or had only mild pain in the wrist with strenuous activity. Flexion-extension of the wrist improved by more than 10 degrees in about half of the patients, and in most of the patients the grip strength increased by five kilograms or more. All but two of the postoperative results were satisfactory, as evaluated by the criteria of Lichtman et al. The osteotomy was effective even in patients who had zero or positive ulnar variance.
http://www.medmedia.com/a8/117.htm
Biomechanical analysis of radial wedge osteotomy for the treatment of Kienbock's disease.
Watanabe K. Nakamura R. Horii E. Miura T.
Journal of Hand Surgery - St Louis. [JC:ia9] 18(4):686-90, 1993 Jul. Biomechanical analysis of force transmission through the lunate was performed with the use of a two-dimensional mathematical model to evaluate the usefulness of radial wedge osteotomy, a procedure that decreases radial inclination, in the treatment of Kienbock's disease. The forces acting on the carpal bones were compared before and after radial wedge osteotomy in 29 patients with Kienbock's disease. The average osteotomy angle was 9.6 degrees. The total force through the lunocapitate joint at the midcarpal level was decreased by 23%, while the total force through the radiolunate and ulnolunate joints at the radioulnocarpal level was decreased by 10% and 36%, respectively. These changes correlated directly with the osteotomy angle and demonstrate decompression of the lunate by radial wedge osteotomy.