Kienböck’s Disease – A Case Report: Treatment of Two Advanced Cases

In the advanced stages of Kienböck's disease, when the lunate or the carpal architecture is compromised, palliative surgical interventions such as proximal row carpectomy or partial or total wrist arthrodesis are generally preferred. Through the presentation of these two advanced cases, we aim to highlight the possibility of adopting a conservative surgical approach to the lunate, provided that its morphology and the carpal architecture remain preserved. Within the limits of a case report, a lunate-preserving strategy - lunate osteosynthesis combined with medial closing wedge osteotomy of the radius - achieved computed tomography-confirmed union and acceptable early functional recovery in two selected Lichtman IIIc cases. Robust conclusions about durability and comparative benefit over established palliative procedures will require larger, prospective studies with longer follow-up.