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

BackgroundLunate 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 Kienbock disease.ObjectivesEvaluation of the relationship between lunate morphology and kienbocks disease. MethodsA total of 106 patients with stage IIIA or IIIB of Kienbock disease at initial presentation were included in this study. Modified Litchman classification system and standardized lateral radiographs were used for staging the Kienbock 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).ResultsThe mean±SD age of the patients was 33.5±9.2 years. Kienbock 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).ConclusionLunate morphology is associated with the severity of Kienbock 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.