Fragmentation and collapse of the carpal lunate in stage HI Kienback's disease is a challenge to both patients and surgeons. Capitate lengthening with a limited fusion as a modification of the procedure described by Giwner, O. eta! in 1966, was performed to twenty patients with stage 111 Kienbock's disease and followed from ten months to twenty-four months after the operation. The motion of the wrist has not been improved in all patients, but pain was generally relieved in all except one patient suffered from severe pain. In comparison to the normal wrist, the grip strength was satisfactory in fifteen patients and was fair in five patients. Three patients developed radiocarpal arthrosis, two patients had non-union and one patient suffered from Sudecles atrophy. Based on the satisfactory clinical and radiologic results found in this study, we recommend capitate lengthening in stage 111 of Kienbock's disease. |
