J Korean Orthop Assoc.  2006 Dec;41(6):947-952.

Limited Intercarpal Arthrodesis in Kienbock's Disease

• Shin HD
• Kim KC
• Woo SM
• Li X
• Kang TH

Abstract

PURPOSE
To compare the treatment results of triscaphe and scaphocapitate arthrodesis in Lichtman's stage III Kienbock's disease.
MATERIALS AND METHODS
Among 25 cases of Kienbock's disease (Lichtman's stage III), who were followed up more than 1 year after surgery from 1997 March to 2005 March, 15 cases of scaphocapitate and 10 cases of triscaphe arthrodesis were reviewed. The average age was 42.6 and the mean follow-up period was 33 months. The clinical and radiology results were analyzed before surgery and at the last follow-up.
RESULTS
In the clinical assessments, there was good pain relief after each procedure and there was a similar limitation of the carpal range of motion before and after surgery. The radiology assessments revealed no difference between the two arthrodeses according to the carpal height ratio and lunate index. Regarding complications, there were 4 cases with a scaphocapitate including 1 nonunion and 4 cases with triscaphe arthrodesis including 2 superficial infections.
CONCLUSION
The scaphocapitate arthrodesis is a technically simple, easy reducible to the anatomical position and produces similar clinical and radiology results to triscaphe arthrodesis. Overall, scaphocapitate arthrodesis appears to be an effective method for treating Lichtman's stage III Kienbock's disease.

Keyword

Lunate; Kienbock's disease; Scaphocapitate arthrodesis; Triscaphe arthrodesis

MeSH Terms

Arthrodesis*
Follow-Up Studies
Osteonecrosis*
Range of Motion, Articular