Management of Wrist Arthritis Secondary to Advanced Kienbock Disease

Abstract

Summary: This review will discuss various surgical options available to the hand surgeon treating advanced Kienbock disease. Development of the extensive wrist arthritis changes seen in stage IV Kienbock disease is a contraindication to techniques which focus on lunate unloading or revasuclarization. Instead, the focus must be on salvage procedures, such as total wrist arthrodesis, proximal row carpectomy, total wrist arthroplasty, or lunate arthroplasty (excision alone, or with various implants).