Lunate revascularization after Capitate shortening osteotomy in Kienbck's Disease

The aim of surgical treatment in the early stages of Kienböck’s disease is to decrease
compressive loading of the lunate to promote revascularization. Capitate shortening osteotomy
is one technique that has been advocated in Kienböck’s disease with ulnar neutral or
positive variance and Lichtman stage I to IIIA. The purpose of this study was to examine the
revascularization process of the lunate after capitate shortening osteotomy.
Methods This was a retrospective study of 9 patients with Kienböck’s disease with Lichtman
stage II or IIIA and ulnar neutral or positive variance. I confirmed avascular necrosis of the
lunate in all the patients by magnetic resonance imaging preoperatively. Capitate shortening
osteotomy was performed through a dorsal approach and fixed with K-wires. I used magnetic
resonance images with fat suppression to detect the revascularization of the lunate after
surgery.
Results The mean follow-up was 12 months (range, 8–16 mo). All patients demonstrated
partial revascularization of the lunate and the mean revascularization time was 4.7 months
(range, 3–7 mo), which was interpreted as the beginning of the revascularization process.
Conclusions Capitate shortening osteotomy is an efficient technique to induce the revascularization
process in the early stages of Kienböck’s disease