treatment of kienbocics disease by lunate excision and scaphocapitate Fusion

ABSTRACT

Excision of the lunate combined with scaphocapitate [SC] fusion was performed for 14 patients with stage III Kienbock's disease. The average age was 21 years and the period of follow-up averaged 14.8 months. The operation was done through a dorsal approach with the use of autogenous bone graft and K wire fixation for the scaphocapitate articulation. Satisfactory fusion occurred in all cases after an average of 8.3 weeks. The procedure was successful in preventing further carpal collapse and scaphoid subluxation. Degenerative arthritis occurred in five patients and mild superficial infection in two patients. The range of motion averaged 29.6° of palmarflexion, 31.1° of dorsiflexion, 22.1° of ulnar deviation and 5.7° of radial deviation. The grip strength averaged 73.9% of the uninvolved side. Pain was markedly reduced in over 85% of the patients, and more than 70% of the patients were able to return to their former heavy manual jobs