Surgical management of Kienböck’s disease with non-negative ulnar variance: A systematic review

The evidence base for managing Kienböck's disease in non-ulnar-negative wrists is limited and heterogeneous. Isolated capitate shortening osteotomy appears to offer reliable symptomatic relief in early and mid-stage disease, whereas combined approaches may be considered in selected advanced cases. These conclusions should be interpreted cautiously given the predominance of low-level evidence. Further multicenter prospective studies are needed to clarify optimal surgical strategies and refine stage-specific treatment algorithms.