[Treatment of semilunar necrosis]

The treatment of Kienböck's disease must be based on the clinical and radiological stage of the lesion. Lengthening or shortening osteotomies of the bones the forearm which seek to rearrange the forces on the lunate are useful only in those cases in which the lesion is reversible or the degenerative changes limited. Compression and fragmentation of the lunate causes instability of the carpus with horizontalization of the scaphoid and subsequent generalised degenerative changes. Intercarpal fusions and lunate and scapho-lunate implants are used in an attempt to avoid total wrist arthrodesis.