Kienböck's disease. Results of treatment with ulnar lengthening

Further experience with ulnar lengthening in the treatment of 22 patients with Kienböck's disease confirms the efficacy of this procedure as observed in a previous series of 20 patients. In this procedure, the joint compressive force is removed from the trabeculae of the convex portion of the body of the lunate that is weakened by avascular necrosis. Subchondral fractures were present in at least 13 of the 22 patients. The technique of ulnar osteotomy, with interposition bone graft supported by a slotted bone plate applied prior to completion of the osteotomy, seems well established. Three patients were lost to follow-up and one required a secondary lunate excision for continuing pain. The remainder of the patients were well satisfied with the procedure.