Lunatum excision and limited intercarpal fusion in advanced Kienböck's disease: scaphocapitate versus capitohamate fusion.

Abstract

This study aimed to compare the clinical and radiological results of scaphocapitate fusion (SCF) and capitohamate fusion (CHF) combined with lunate excision in advanced Kienböck's disease. Patients over 18 years of age who were in stages IIIB-IIIC according to the Lichtman classification, and who had at least 1 year of follow-up, were included in the study. All patients had unilateral disease. Patients were divided into 2 groups according to whether they had CHF or SCF. The range of motion (ROM) and grip strength of the operated and contralateral active wrist joint were measured. Radiological evaluation of the severity of the disease was determined preoperatively using Lichtman staging. Preoperative and postoperative carpal height ratios (CHRs) were measured on anteroposterior radiographs. The presence of osteoarthritis was evaluated. Functional outcome was assessed using the Disability of the Arm, Shoulder, and Hand (DASH) and Visual Analogue Scale (VAS) scores. The mean age of the 27 patients (12 CHF and 15 SCF) was 32.5 years. There was no statistically significant difference between the 2 groups in terms of demographic characteristics, Lichtman stages, and mean follow-up time. No difference between the groups regarding ROM, grip strength, VAS, and DASH scores could be found. The preoperative and postoperative CHRs were compared, and no difference was found between the groups. Although SCF has some advantages over CHF regarding joint ROM and clinical scores, no difference was found between the groups (clinically and radiologically). Both SCF and CHF combined with lunate excision seem to be effective in the treatment of advanced Kienböck's disease in the mid-term.   Cite this article as: Sener İM, Ozturk T, Aldemir C, et al. Lunatum excision and limited intercarpal fusion in advanced Kienb.ck's disease: scaphocapitate versus capitohamate fusion. Acta Orthop Traumatol Turc. 2026, 60 (1), 0270, doi:10.5152/j.aott.2026.25270.