Vol. 6, Issue 1, Part B (2024)

Background: Kienböck’s disease presents challenges in wrist management, with varying effectiveness of surgical interventions depending on disease stage. This study evaluates distal capitate shortening combined with capitometacarpal arthrodesis in patients with stage II and IIIA Kienböck’s disease.
Methods: Patients were classified into stage II and IIIA based on radiographic findings and treated with the aforementioned surgical technique. Postoperative outcomes were measured in terms of pain relief, range of motion (ROM), grip strength, and Modified Mayo Wrist Score (MMWS). Statistical comparisons were made between the stages.
Results: For stage II patients, significant improvements were noted: pain score reduced by 40% (p< 0.01), ROM increased by 25% (p< 0.01), grip strength enhanced by 30% (p< 0.05), and MMWS improved by 35 points (p< 0.01). In stage IIIA patients, pain relief was only 15% (p = 0.12), ROM improved by 10% (p = 0.23), grip strength by 12% (p = 0.18), and MMWS by 10 points (p = 0.22). Failure rates were higher in stage IIIA, with 40% showing unsatisfactory outcomes.
Conclusion: Distal capitate shortening combined with capitometacarpal arthrodesis is effective for stage II Kienböck’s disease, significantly improving postoperative outcomes. However, the technique is less effective for stage IIIA, with high failure rates and limited symptom relief. The lunate height ratio may be a useful prognostic indicator for surgical success.