Outcomes of wrist denervation and core decompression of the radius for Kienbock's disease

The definitive treatment of Kienbock's disease has yet to be determined. Wrist denervation combined with core decompression of the radius has not been previously studied as a combined treatment for Kienbock's disease.

The purpose of this study was to assess the efficacy of simultaneous wrist denervation and core decompression of the radius in the treatment of Kienbock's disease.

All patients with Kienbock's disease who were treated with simultaneous core decompression of the radius and wrist denervation by a single surgeon at a single institution from 2012 to 2022 were contacted for this study. Demographic, clinical and radiographic data were collected retrospectively. Quick DASH and Upper Extremity PROMIS scores were collected prospectively.

Ten patients met inclusion criteria. Mean age at time of surgery was 31 years old. One patient was Lichtman stage 2, 5 patients were stage 3a, and 4 patients were stage 3 b. Patient reported outcomes were collected at a mean of 5.1 years since surgery (7 month-10.3 years). The mean Upper Extremity Promise T-score was 49 (median 52; age >/ = 40, normal 51.2 ± 8.2; age <40, normal 55.9 ± 6.6) and the mean Quick DASH score was 13 (median 7; normal 0-20). Nine of 10 patients reported they were satisfied with the procedure, and 100 % of patients said they would choose to have the procedure again.

Patients with Lichtman stage 2, 3a and 3 b Kienbock's disease treated with simultaneous core decompression and wrist denervation reported minimal to no disability at 5 years after surgery. All patients in this study reported they would choose to have the surgery again to treat their Kienbock's disease.