Advanced Kienböck's disease treated with implantation of a tendon roll and temporary partial fixation of the wrist.

Twenty-one patients with advanced Kienböck's disease were treated by implantation of a tendon roll and temporary partial fixation of the wrist. There were 13 women and eight men. Their ages at the time of operation ranged from 24 to 72 years. According to Alexander and Lichtman's classification, 12 patients were stage IIIb and nine stage IV. After implantation of the tendon roll, the scaphotrapezio-trapezoidal joint was fixed with Kirschner wires in 19 patients, and the scaphocapitate joint with absorbable pins in two. Postoperative wrist pain disappeared in nine patients and was reduced in 12. The mean postoperative total arc of flexion and extension of the wrist increased from 91 degrees to 103 degrees, and mean grip strength improved from 11.5 to 17.2 kg. Loosening of Kirschner wires during partial fixation of the wrist was seen in six cases, and required early removal of the loose wires.