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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.
The extracorporeal shockwave head was directed specifically to the dorsal aspect of the lunate bone.
According to the mechanical theory, avascular necrosis of the lunate bone is a consequence of a slow progressive collapse of the lunate under excessive bony stresses and excessive loading.
14,15) On the palmer surface, the lunate bone gets blood supply from the palmer intercarpal arch, the palmer radiocarpal arch, and communicating branches from the anterior interosseous artery and the ulnar recurrent artery.
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.