[STT arthrodesis for treatment of stage III semilunar bone necrosis: functional outcome]

Scapho-trapezio-trapezoid arthrodesis for the treatment of Kienböck's disease is recommended as a salvage procedure for Stage III A and B in the Lichtman classification. This study reviews the results of 26 patients with stage III of Kienböck's disease treated by STT-arthrodesis. 26 patients (16 male, 10 female) were treated by STT-arthrodesis between 1993 and 1998. Fusion was established after seven weeks average. All patients were examined, the mean follow-up time was 35 (10 to 72) months. Active range of motion showed 63% of extension/flexion and 51% of radial/ulnar deviation on average, compared to the uninjured hand. Mean preoperative and postoperative pain scores were 58.4 (non-stress) vs. 82.5 (stress) and 16.4 (non-stress) vs. 33.7 (stress), eight patients claimed complete pain relief. Grip strength improved to 71% of the opposite side. Total DASH score reached 24.8. 20 of the 26 patients were satisfied with the final result and would undergo the operation again. We found a significant reduction of pain, a slightly reduced grip strength and a satisfying functional wrist mobility after STT-arthrodesis. Carpal height was unchanged and the carpal collapse did not progress. The mid-term data support that STT-arthrodesis will stand the test of time.