Radial shortening with osteosynthesis in the treatment of Kienböck's disease.

Since 1970 we have been using an original method of epiphyseal osteotomy to produce radial shortening in the treatment of Kienböck's disease. This is based on the experience of treating unstable Colles fractures with 2 transcutaneous Kirschner wires; they consolidate easily and quickly. The advantages are: a radial dorsal approach and an operation which is easily performed; an increase in the vascularization induced in the proximal area of the lunate; reduction of immobilization to 3-4 weeks; absence of complications which are common in other methods; immobilization limited to the wrist alone; resumption of work after 6-8 weeks; radial shortening of 5-8 mm with effective dynamic and static unloading and better trophism of the lunate; regression of pain and recovery of prehensile power in the hand in 28 cases followed up for 5 to 16 years after surgery.