[Graner's intercarpal arthrodesis]

Graner's intercarpal arthrodesis was performed in 10 patients with Kienböck's disease. The procedure consists in excision of the deformed lunate bone, cartilage resection in the adjacent intercarapal joints (Fig. 5), transverse osteotomy of the capitate bone, transposition of its proximal part to the place of the lunate, fixation with Kirschner wires and filling all the remaining bone spaces with cancellous bone. Postoperative immobilisation was necessary for about three months. Eight of these patients were reviewed 1 to 4 years postoperatively. 40% were free of pain, 50% have some pain and 10% moderate to severe pain. The range of motion in the wrist was restricted between one and two thirds, the strength of the grip on average was one third of the normal values. Severe arthrotic changes were considered as contraindications for this procedure, because their further development was no stopped by the intercarpal arthrodesis and will interfere with the positive aspects of this procedure.