Back to Annual Meeting Posters

The osteonecrosis of the semilunate or Kienbock disease, is still a challenge presently in relation to understanding the etiology and treatment . Lichtman et al divided into 4 stages ranging from incipient signs of osteonecrosis of semilunate until its complete colapse,. But, the doctor may be induced to error, as for the staging of the disease, if he/she considers other factors such as duration of the illness, intensity of pain and range of motion. The proposal of our work was to conduct the arthroscopic study of the wrist of patients with the Kienböck’s disease in the 3A and 3B stages, in order to evaluate the articular conditions of the carpus, establishing a parallel with the preoperative clinical condition. We evaluated, arthroscopically, 15 patients who had the Kienböck’s disease in stage 3, whom 5 were type 3A and 10 were type 3B, according the classification of Lichtman. The inclusion criterion was the patients who showed symptoms in the wrist, and whose radiographic examination showed the image of idiopathic osteonecrosis of the semilunar, classified as stage 3 from LICHTMAN’s, and without past surgery in the wrist.. We believe that stage 3 is which generates more doubts about choice of better treatment, since the colapse of semilunate addition, we have to consider the amendment of the scaphoid angle and its consequences in the compromised joint. The arthoscopic study of the wrist with Kienbock disease could provide subsides to make the best decision surgery