Comparison of partial and total capitate shortening osteotomies in the treatment of Lichtman stage 2–3A Kienböck’s disease

Abstract

Introduction:

This study compared clinical and radiological outcomes of partial and total capitate shortening osteotomies in Lichtman stage 2–3A Kienböck’s disease.

Methods:

Fifty-one patients were retrospectively analysed. Functional outcomes included pain scores, grip and pinch strength and range of wrist motion. Radiological assessment comprised carpal height ratio, lunate dimensions, capitolunate and scapholunate angles, and lunate revascularization on magnetic resonance imaging. Osteoarthritic changes were identified from follow-up radiographs.

Results:

Both procedures significantly improved pain, grip, pinch strength and range of motion from the baseline. Between-group comparisons revealed similar clinical and radiological outcomes, except for greater grip strength improvement in the partial osteotomy group. Osteoarthritic progression occurred in four patients per group, without significant differences. MRI findings demonstrated comparable lunate revascularization and disease stabilization.

Conclusion:

Partial and total capitate shortening osteotomies are effective for Lichtman stage 2–3A Kienböck’s disease, with grip strength improvement more pronounced in the partial capitate shortening group, while other outcomes were comparable.

Level of evidence:

III