Lunate revascularisation associated to a shortening osteotomy of the radius for the treatment of Kienböck’s disease

Kienböck’s disease was described by Kienböck in 1910. It is anavascular necrosis of the lunate, its natural history evolves to thecollapse of the carpus with a secondary degenerative evolution.Epidemiology is poorly known and is still discussed, except for posttraumatic cases. The negative ulnar variance is considered by amajority of authors as a predisposing factor to Kienböck’s disease.The therapeutic principle evolves according to stages of the diagnoses.Shortening of the radius and lengthening of the ulna are satisfactoryprocesses in the biomechanical plan because they increasethe constraints transmitted by the ulna by discharging the lunate.Revascularisation of the lunate associated with a shortening of theradius seems a more daring and more ambitious technique. As forthe very advanced forms, they require palliative techniques such aswrist denervation, first raw carpectomy or four bone arthrodesis.We report our experiment of a series of 22 cases treated between1994 and 2000 with a minimum 5 year-follow-up, associating arevascularisation of the lunate by a former graft