[Intracarpal revascularization arthrodesis with transposition of the capitate bone (Graner type II)]

Necrosis of the lunate requires surgery when it is painful and disabling. Decoulx's stage III is too often beyond reconstructive surgery (lengthening of the ulna, shortening of the radius), while such disabling procedures as wrist arthrodesis are not indicated yet. The intracarpal revascularizing arthrodesis with transposition of the capitate (described by Graner in 1966) is to be considered at this stage. The creation of a new condylar arch coated with cartilage, resembling the physiologic arch, and the preservation of the radio-carpal mobility, allows the return of sufficient motion and strength for everyday needs. The wrist often gets painfree; this procedure should thus be considered as a palliative salvage operation, none the less useful in young manual workers.