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Treatment of Kienböck disease by lunate core decompression.

PURPOSE: Kienböck disease is characterized by avascular necrosis of the lunate bone, which is usually progressive without treatment. This study examined lunate core decompression for its treatment potential.

METHODS: We surgically treated 20 patients with stage 1 to 3b Kienböck disease with lunate core decompression. We evaluated pain, range of motion, functional disability, and radiographic indices in these patients at baseline and 5 years after surgery.

RESULTS: The mean age of the patients was 29 years; 16 were men. Ten patients had Lichtman stage 1 disease, 6 had stage 2 disease, 3 had stage 3a, and 1 had stage 3b disease. Range of motion scores showed meaningful improvement. Two patients did not improve with this technique and were revised with radial shortening procedures.

CONCLUSIONS: Lunate core decompression is a simple surgical procedure that is effective in the treatment of Kienböck disease.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

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