Outcome of scaphocapitate arthrodesis for treatment of Kienböck’s disease with and without lunate excision

Abstract

Background Kienbock’s disorder is a degenerative wrist disease that is largely defined by idiopathic lunate bone avascular necrosis. This research objective was to assess the Scaphocapitate arthrodesis (SCA) efficacy in terms of wrist motion improvement, pain relief, and radiographic alterations in comparison to SCA without lunate excision. Methods This observational prospective study was conducted on 20 patients with Kienbock’s disease (stage ІІІB), who attended Benha University Hospital Orthopedics Clinic or Shebin Teaching Hospital. All patients were allocated into two groups; group 1 ( n =10) involved patients with lunate excision and group 2 ( n =10) involved patients without lunate excision. All participants were assessed through clinical examination full history taking, and radiological assessment by plain radiography and confirmed by computed tomography to assess if there is arthritic changes or not and MRI. Results Regarding the functional outcome, the postoperative grip strength and modified mayo wrist score increased significantly in group 1 as regard to group 2 ( P =0.001, 0.033). The pain outcome differed significantly among both groups ( P =0.019), being better in group 1 compared with group 2. The satisfactory outcome significantly differed between both groups ( P =0.001), group 1 showed superior satisfaction compared with group 2. Conclusion SCA with lunate excision showed superior radiological and functional outcomes, better pain relief, and a higher satisfaction rate in Kienbock’s disease management.