Evaluation of Wrist Function in Scaphocapitate Fusion For Management of Kienböck’s Disease: A Prospective Study

Abdelfattah, Hesham; Abdelshafy, Islam; Abdelaziz, Wael

doi:10.21608/bmfj.2025.303514.2124

Evaluation of Wrist Function in Scaphocapitate Fusion For Management of Kienböck’s Disease: A Prospective Study

Articles in Press

Document Type : Original Article

Authors

¹ Department of Orthopedic Surgery, Faculty of Medicine, Benha University, Egypt

² Assistant Professor of Orthopedic Surgery, Faculty of Medicine, Benha University, Egypt

³ Professor of Orthopedic Surgery, Faculty of Medicine, Benha University, Egypt

10.21608/bmfj.2025.303514.2124

Abstract

Background: Kienböck's disease is a condition characterized by avascular necrosis due to loss of blood supply of the lunate bone in the wrist. Scaphocapitate fusion is one surgical option for managing advanced stages of Kienböck's disease. This work aimed to evaluate the scaphocapitate fusion outcome for treatment of Kienböck’s disease.
Methods: In this prospective, clinical analytical and experimental study 50 patients with Kienböck’s disease, stage II & III were recruited from Orthopedic surgery department of Benha University Hospitals. All included patients was subjected to full history taking, clinical evaluation, radiographic evaluation, medical assment and laboratory investigation.
Results: The mean range of motion of the wrist was 32.58 ± 2.79 and 32.46 ± 2.71 degrees preoperatively in flexion and extension, respectively, it was increased to 42.18 ± 2.81 and 42.44 ± 2.69 degrees postoperatively in flexion and extension, respectively. Comparison between preoperative and postoperative values showed statistically significant difference (p =0.011 & 0.013, respectively). The final outcome after the follow-up period indicated that 8 patients (16%) were excellent, 31 cases (62%) were good and 11 cases (22%) were fair measured radiologically by Mayo score system. Minimum complications were recorded 2 cases with persistent pain; 1 mild and 1 moderate and only one case with malunion.
Conclusions: Scaphocapitate fusion for Kienböck’s disease stage II and III with preservation of the lunate and radiocarpal joint maintains wrist motion and significantly relieves pain. Scaphocapitate arthrodesis achieved a high rate of satisfactory clinical and radiological results with minimal complications and preserves carpal height.

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