Clinical and radiological outcomes in treatment of Lichtman stage IIIB Kienböck’s disease by scaphocapitate fusion: hospital based prospective interventional study

Background: This investigation assessed the effectiveness of scaphocapitate (SC) arthrodesis with lunate preservation in treating patients with stage IIIB Kienböck's disease, characterized by neutral ulnar variance. Additionally, the study sought to identify potential differences in treatment outcomes among patients with stage IIIB Kienböck's disease. Methods: A total of 38 patients with stage IIIB Kienböck's disease underwent scaphocapitate arthrodesis, stabilized using Herbert compression screws. Each participant underwent comprehensive pre- and post-operative evaluations, including assessments of pain (VAS score), range of motion (ROM), grip strength and functional outcomes (DASH score and PRWE score). Results: The mean follow-up period for all patients was 17.81 months. Bony union was achieved at an average of 14 weeks, with most patients returning to work within 24 weeks. Comparing pre- and post-operative outcomes, significant improvements were observed: VAS scores decreased from 39.34 to 15.53, grip strength increased from 18.03 to 29.47% and the RS angle was corrected from 84.08° to 59.34°. Conclusions: This study demonstrates that surgical intervention can significantly enhance wrist mobility, increase grip strength and alleviate pain, ultimately facilitating patients' return to a higher level of functional ability and overall well- being.