Objectives:

In this study, it was aimed to evaluate the surgical treatment results of scaphocapitate arthrodesis in Lichtman classification stage 3b and 3c Kienböck disease.

Materials and Methods:

Eleven patients who had undergone scaphocapitate arthrodesis were included in the study. The mean age of the patients was 41 years. Lunatum was excised in 5 patients and preserved in 6 patients. Fixation was performed with a single screw in 2 patients and with two screws in 9 patients. The mean follow-up time was 18.6 months. Grip and key pinch strengths and wrist range of motion of both hands were recorded at the last follow-up. Quick Disabilities of the Arm, Shoulder and Hand (QDASH) score, Mayo wrist score and VAS scales for the operated side were also evaluated and recorded. In direct radiographs, bony union, proximal migration of the capitatum and joint degeneration were evaluated.

Results:

The mean postoperative VAS score was 2.81, and the mean QDASH score was 14. The average Mayo wrist score was 63.63. Postoperative mean wrist flexion was 14.54 degrees and extension was 34.72 degrees. Compared to the non-operated side, there was an 81% reduction in flexion and a 50.4% reduction in extension. The mean grip strength was 15.51 kg and pinch strength was 5.63 kg on the operated side. There was a significant difference in grip strength (p=0.011) compared to the non-operated side, but there was no significant difference in pinch strength values (p=0.417). Radiographically, union had occurred in all patients, there was no proximal migration of the capitatum, and no signs of joint degeneration were detected.

Conclusion:

After scacocapitate arthrodesis, a significant decrease in wrist joint movements occurs. However, the maintained range of motion remains adequate for functionality. The clinical results are satisfactory as the pain is significantly reduced. This method is a valid treatment option in stage 3b and 3c Kienböck’s disease with low complication and high union rate.

Keywords: Kienböck Disease, Scaphocapitate Arthrodesis, Lichtman Classification