The Role of Lunate Morphology in the Severity of Kienböck Disease: A Retrospective Study

Abstract

Background: Lunate morphology has been associated with several wrist pathologies. In this study, we aimed to find how lunate morphology (absence or presence of hamate facet) affects the severity of Kienböck disease. Objectives: Evaluation of the relationship between lunate morphology and kienbocks disease. Methods: A total of 106 patients with stage IIIA or IIIB of Kienböck disease at initial presentation were included in this study. Modified Litchman classification system and standardized lateral radiographs were used for staging the Kienböck disease. Lunate morphology was investigated on plain radiograph and computed tomography scan or magnetic resonance imaging and was classified into type I (absence of hamate facet) and type II (presence of hamate facet). Results: The mean±SD age of the patients was 33.5±9.2 years. Kienböck disease stage IIIA and IIIB were identified in 68 (64.2%) and 38 (35.8%), respectively. Hamate facet was present in 65 (61.3%) patients and absent 41 (38.7%) patients. A significant association was found between lunate morphology and stage of disease so that the number of patients with lunate type I was significantly more in stage IIIB and number of patients with lunate type II was significantly more in stage IIIA (p<0.001). Conclusion: Lunate morphology is associated with the severity of Kienböck disease in patients initially presented with stage IIIA or IIIB. These associations could be implicated to prevent disease progression as well as to optimize the outcome of treatment.