Abstract / Summary
Abstract Background Kienböck’s disease (KD) is a rare avascular necrosis of the lunate. For stage III disease, lunate excision combined with tendon interposition arthroplasty is one of the operative options, but clinical evidence remains limited. This study aimed to evaluate the clinical outcomes of lunate excision combined with palmaris longus tendon ball arthroplasty for stage III KD and to describe the surgical technique. Methods Six patients with stage III KD treated by lunate excision combined with palmaris longus tendon ball arthroplasty in our department were retrospectively reviewed. The necrotic lunate was completely excised, and the defect was reconstructed with a tendon ball fashioned intraoperatively by harvesting and braiding both palmaris longus tendons. Clinical outcomes-including pain relief, return to daily and occupational activities, wound healing, and complications-were evaluated at a mean follow-up of 12 months. This report was prepared in accordance with the CARE guidelines. Results All six patients completed the follow-up. Surgical incisions healed within 2 weeks without infection, skin necrosis, or other complications, and all patients returned to their previous occupations within 4 weeks. At the final follow-up (mean 12 months), all patients reported pain relief and maintained functional wrist use for daily and occupational activities. Conclusions Lunate excision combined with palmaris longus tendon ball arthroplasty provided satisfactory short-term outcomes in this small series and may be considered a viable operative option for stage III KD. Larger comparative studies with longer follow-up are needed to confirm these findings.