RADIAL RECESSION OSTEOTOMY FOR KIENBOCKS-DISEASE

Sixty-eight patients underwent radial recession osteotomy for avascula r necrosis of the lunate were retrospectively evaluated after an avera ge follow-up period of 52 months. Twenty-five patients had undergone 1 or more additional procedures concurrently for treatment of Kienbock' s disease. Pain diminished in 93% of patients, grip strength improved, and wrist motion was preserved; 75% of patients continued in their or iginal occupations, including heavy labor. Surgical complications were uncommon. Four patients subsequently underwent salvage procedures, in cluding 2 total wrist arthrodeses. Three of these 4 patients were rece iving workers' compensation. One third of patients demonstrated lunate healing after joint levelling. Preliminary results suggest that conco mitant lunate revascularization or vascularized bone grafting may impr ove the radiographic result. With rare exceptions, radial recession os teotomy relieves pain and improves function in Kienbock's disease.