Capitate Osteotomy and Intra-Capitate Bone Graft without Intercarpal Arthrodesis in Kienbock Disease

There are many different methods of treatment for Kienbock's disease or avascular necrosis of the carpal lunate. We are reporting our experience with lunate excision, capitate osteotomy and inter capitate bone grafting. Eleven male patients with stage III lunatomalacia treated by lunate excision capitate osteotomy and intra-capitate bone grafting were assessed with a mean follow-up of 6 years (2-10 years). The cases were evaluated in terms of pain, function, grip power and return to pre-treatment activities. Pain decreased significantly in all but one case. Grip strength had returned to above 70% of the strength of the opposite hand in all but one patient. Capitate osteotomy and inter-capitate bone graft without intercarpal arthrodesis in Kienbock disease is a safe and reliable technique for stage III disease.