[Long-term results of conservatively operated necroses of the lunate bone]

The authors present a follow-up of 21 patients treated surgically for lunate bone necrosis on average 19.1 years prior to evaluation. A procedure is called conservative when the shape of the lunate is not destroyed by the operation and the mechanism of the wrist is preserved. This paper shows that these methods are indicated in early stages of Kienböck's disease, but despite some satisfied patients they show generally poor results when used for the late stages with fractured lunate and degenerative signs of the entire carpus. Emphasis should be put on the need for early diagnosis of obscure wrist pain to make early treatment possible, in order to avoid later limitation in the range of motion of the carpus. The authors also report their application to the lunate and its problems of Ficat's measurement of bone marrow pressure in necrosis of the femoral head.