Management of stage 3 Kienbock's disease by scapho-trapezio-trapezoid fusion [STT Fusion]

ABSTRACT

In this study, 34 patients having unilateral stage 3 Kienbock's disease were followed up after scapho-trapezio arthrodesis [STT fusion] between 1997 and 2002 [24 females and 10 males with an average age at the time of surgery of 23.2 years]. The follow up ranged between 12 and 52 months with an average of 38.7 months. In conclusion, in spite of the decreased postoperative range of motion, STT fusion is effective in reducing the pain and improving the grip strength in cases of Kienbock's disease. STT fusion improves and prevents the collapse of the carpus in stage 3 Kienbock's disease. The decreased postoperative range of motion [ROM] could be improved by adding radial styloidectomy to STT fusion to decrease radioscaphoid impingement. The adjustment of scaphoid orientation intra-operatively is a technical defect which should be taken in consideration to have a better outcome from STT fusion