Background:
Capitate shortening is the best decompression procedure in the
management of Kienbo¨ck’s disease in patients with ulnar neutral
or positive variance, although carpal collapse develops inevitably.
The current study was to report our experience in partial capitate
shortening osteotomy as an alternative procedure.
Methods:
This was a prospective study of 20 patients with Lichtman stage
II and IIIa Kienbo¨ck’s disease managed by partial capitate
shortening osteotomy.
Results:
At final follow-up (average 36.5 mo), visual analog pain scores
improved significantly postoperatively to 3.3. Flexion and
extension improved from 62% ( ± 17%) and 52% ( ± 21%)
preoperatively to 63% ( ± 13%) and 68% ( ± 13) postoperatively,
respectively. The power grip improved significantly from 49%
( ± 16%) to 63% ( ± 12%) postoperatively. The average quick
Disability of the Arm Shoulder and Hand Score improved from
60.8( ± 13.8) to 38.3( ± 13.9) postoperatively.
Conclusions:
Partial capitate shortening is a simple and effective procedure for
the management of ulnar neutral or ulnar positive Kienbo¨ck’s
disease before the onset of radiocarpal arthrosis without
violation of scaphocapitate joint thus avoiding carpal collapse
that follows complete capitate shortening.
Type of Study/Level of Evidence:
Therapeutic IV.