Table 1.

Treatment of Kienböck’s disease.

Osseous (Lichtman)	Vascular (Schmitt)	Principle	Technique
0 I, II,IIIA	A,B	Unload Radiolunate	Immobilization, Joint leveling procedures Radial shortening osteotomy, Ulnar lengthening, capitate shortening
		Revascularization	Vascularized bone graft core decompression, Radius Metaphyseal core decompression (MCD)
IIIB	B	Unload Radiolunate	Radial shortening osteotomy
		Lunate excision + Bypass disease column/or proximal shift of capitates (restore lunate function)	SC fusion, STT fusion capitate osteotomy and transposition
		fuse disease column	RSL fusion
			proximal row carpectomy
IIIC	C	Lunate Salvage	Internal fixation
		Lunate excision	Lunate replacement and interposition (tendon, silicon, pyrocarban prosthesis)
		Lunate excision + Bypass disease column/or proximal shift of capitates (restore lunate function)	SC fusion, STT fusion capitate osteotomy and transposition
		fuse disease column	RSL fusion
			proximal row carpectomy
IV	C	Wrist Salvage	Wrist arthrodesis, wrist arthroplasty