Kienböck's Diseases Treatment. A Novel Technique via Distal Capitate Shortening Accompanied by 3rd Metacarpal Base Fusion in Neutral Variance Ulna

Abstract

Background: Since there is not a definite cause for Kienböck's diseases despite appropriate knowledge of lunate bone blood supply, so there is a great debate about the ideal treatment protocol for treatment of Kienböck's diseases. Objective: The aim of this study is to assess outcome of combining distal capitate shortening and fusion to the base of the third metacarpal bone for treatment of Kienböck's disease (Lichtman stage II or stage IIIA) with neutral ulna variance. Methods: Twenty patients with 20 consecutive Kienböck's disease, their age mean was 26.1(SD 5.6) y. Patients were evaluated radiologically and clinically including pre-and postoperatively for pain, (ROM) and grip strength. Functional evaluation was carried out using (MMWS). Results: The final postoperative (MMWS) showed increasing from 17 (SD 2.5) to 88.5 (SD7.3). Conclusion: The technique of distal capitate shortening with capito-metacarpal fusion yielded satisfactory results especially for treatment of stage II, than in stage IIIA.