Wrist denervation procedures in the treatment of Kienböck's disease.

In almost all papers on wrist denervation, indications for denervation in Kienböck's disease has been mentioned without exact data. A detailed analysis of our clinical data on 61 patients proved the positive effect with respect to pain relief. In the 47 patients in which the denervation was combined with other procedures, such as radial shortening, ulnar lengthening, lunate excision, and replacement by silicone or tendon, pedicled pisiform transposition, and STT arthrodesis, a very high rate of patients (76%) had no complaints or pain only with heavy manual work. Of these treated patients, 88% were very or remarkably satisfied. About the same success rate was found in cases in which the denervation was applied as a single procedure. The extent of denervation was different; therefore, it can be concluded that partial or complete denervation has its value as an additional or single procedure in the treatment of Kienböck's disease, especially in the advanced stages (Decoulx's stages III and IV).