Results of scaphocapitate arthrodesis with lunate excision in advanced Kienbock disease at 10.7-year mean follow-up

摘要

Scaphocapitate arthrodesis with lunate excision was performed for treatment of advanced Kienbock disease in 17 patients (18 wrists). Ten were women and seven men. Five were Lichtmann Stage IIIA, 12 Stage IIIB, and one Stage IV. Minimum follow-up period was 24 months; mean follow-up was 10.7 years (range 2.3 to 22 years, SD 7.1). At the latest follow-up, six patients were very satisfied, nine were satisfied and two were disappointed. Pain was significantly decreased in all cases. Wrist mobility was unchanged. Grip strength was significantly increased. Consolidation of the arthrodesis was confirmed in 17 wrists. We encountered a scaphocapitate nonunion at 12 years follow-up and two cases of styloscaphoid arthritis at 17 and 22 years. Scaphocapitate arthrodesis with lunate excision performed in an advanced stage of Kienbock disease significantly alleviates pain, while preserving functional mobility and satisfactory grip strength in the long term. Level of evidence: IV