DISCUSSION: In advanced kienbocks disease the progressive collapse of the lunate bone alters biomechanics of the surrounding carpal bones producing proximal capitate migration and decreased carpal height.
In our case report we have done scaphocapitate arthrodesis to stabiles the midcarpal joint, preventing proximal migration of carpal bone and offload the lunate bone. Scaphocapitate fusion was achieved in 3 months post operation.
The extracorporeal shockwave head was directed specifically to the dorsal aspect of the
lunate bone. The patient received 1500 shocks at 8 Hz with no improvements in pain or function.
Joysticks are placed into the scaphoid and
lunate bones. One 0.062 inch Kirschner wire is placed in the distal aspect of the scaphoid from the dorsal side.
SLI is diagnosed with a gap or separation between the scaphoid and the
lunate bones on a posterior anterior wrist X-ray.
To gain stabilization of the wrist, the scaphoid and
lunate bones in the wrist were fused to the radius, one of the bones of the forearm.
The scapholunate interosseous ligament (SLIL) is located dorsal to the RSL ligament; to the radial and ulnar sides are the articular surfaces of the scaphoid and
lunate bones, respectively.