Scaphotrapeziotrapezoid (STT)-arthrodesis in Kienbock's disease

This study reviews the results of 59 of 84 patients with severe Kienbock's disease who were treated with STT fusion. The average follow-up period was 4 (ranges: 2-8 years). The average arc of wrist extension and flexion was 67 degrees (60% of the contralateral side, 81% of pre-operative range) and that of ulnar and radial deviation was 31 degrees (52% of the contralateral side, 56% of pre-operative range). Pre-operative pain values (VAS) were 56 (non-stress) and 87 (stress) and were significantly higher than the postoperative values of 12 (non-stress) and 41 (stress). Grip strength improved from 45kPa pre-operatively to 52kPa postoperatively. The mean modified Mayo wrist score was 63 points. The patients reported low disability in the DASH scores, with an average of 28 points. Our data show that STT fusion is a reliable and effective treatment for pain relief and offers a good functional result in advanced stages of Kienbock's disease. However the long-term effect of this procedure on radioscaphoid and other intercarpal joints is yet to be determined.