Single-Cut Single-Screw Capitate-Shortening Osteotomy for Kienbock's Disease

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Wrist Biomechanics

Background:

• Kienbock's disease involves lunate compromise, leading to carpal instability and arthritis.
• Early intervention with joint leveling procedures aims to unload the lunate.
• Capitate shortening is indicated for Kienbock's disease with positive ulnar variance.

Purpose of the Study:

• To describe a simplified technique for capitate shortening in early Kienbock's disease.
• To evaluate the rationale and outcomes of this minimally invasive procedure.

Main Methods:

• A single-cut osteotomy with single-screw stabilization was performed.
• The technique involves a 1.5mm capitate shortening.
• Three patients with early Kienbock's disease underwent the procedure.

Main Results:

• All patients experienced significant pain relief and improved function/grip strength at 1-2 year follow-up.
• No infections, nonunions, avascular necrosis, or need for salvage procedures occurred.
• Complete pain resolution was not achieved in all cases.

Conclusions:

• The simplified capitate shortening technique is straightforward and less traumatic to capitate vascularity.
• This method yields good short-term functional outcomes for early Kienbock's disease.
• It represents a viable option for managing specific wrist conditions.