Retrospective Study of Clinical Results of Anthovy's Technique with Scaphocapitate and Hamatocapitate Arthrodesis in Advanced Kienbock's Disease

Abstract

Purpose : A retrograde analysis of the clinical results of 11 cases of Kienbock's disease (Lichtman stage III), who underwent surgery for scaphocapitate or hamatocapitate arthrodesis followed by a rolled palmaris tendon replacement after a collapsed lunate excision. Materials and Methods : This study followed-up 11 patients diagnosed with advanced Kienbock's disease for more than 5 years from January 1989 through May 2000. The patient’s age ranged from 25 to 65 years old. Among the 11 patients, 7 patients received hamatocapitate arthrodesis, and the remainder received scaphocapitate arthrodesis. The Evans’ scoring system was used for the clinical evaluation. Results : After surgery, all patients showed complete radiologic fusion and an increase in grip strength, and most patients showed an increase in the ROM of a wrist joint, particularly in the group who received hamatocapitate arthrodesis. Conclusion : In advanced Kienbock’s disease, a lunate excision followed by rolled tendon replacement with limited intercarpal arthrodesis showed relatively good results during the follow-up period, and had a particularly better ROM of the wrist joint in hamatocapitate arthrodesis, than the scaphocapitate arthrodesis because of the arthrodesis between the proximal and distal carpal row in the biomechanical aspect of the carpal bone.