Triscaphe arthrodesis versus radial osteotomy for the treatment of Kienboeck disease

Aim: Kienböck’s disease is most frequent and well known among the osteonecrosis that involves the wrist. The aim of our study is to evaluate a medium-short follow-up on patients submitted to radial shortening osteotomy, and to evaluate a long term follow-up, on the cases dealt with Scaphotrapeziotrapezoid (STT) arthrodesis. Methods: We retrospectively included 14 patients affected by Kienböck’s disease from 1985 to 2003. We have used subjective parameters and also the objective criteria was measured. Lichtman classification was used to decide the treatment choice. Results: Arthrodesis STT: At the 16.5 year average follow-up period, nobody showed articular degenerative alterations. None of the cases showed a lunate collapse. Radial shortening: After an average of 2.8 year follow-up, nobody showed degenerative lesions of the wrist or development of the collapse of the lunate bone. No patient was unsatisfied with the obtained results. Two patients from the STT group have declared to be satisfied, another one has declared to be fairly satisfied, and the others fully satisfied. Two patients from the radial osteotomy group have declared to be satisfied. The remaining patients were fully satisfied. Discussion: Comparing the two techniques, although the follow-up period differs, arthrodesis STT seems to be associated to slightly inferior results compared to the radial shortening, from an objective and subjective point of view. The difference is probably justified by the absence of surgical trauma on the radio-carpal joint.