{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T10:20:10Z","timestamp":1781346010373,"version":"3.54.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018778","name":"Al-Azhar University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018778","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Kienb\u00f6ck\u2019s disease is a progressive avascular necrosis of the lunate that causes wrist pain and functional impairment. Surgical intervention is often needed for advanced stage IIIB disease to relieve symptoms and preserve the carpal structure. Scaphocapitate (SC) arthrodesis is an established technique, but the value of lunate excision versus preservation remains debated. This study prospectively compared the outcomes of SC arthrodesis performed with and without lunate excision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      This prospective comparative study included 38 patients with stage IIIB Kienb\u00f6ck\u2019s disease, who were allocated to receive SC arthrodesis with lunate preservation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919) or lunate excision (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919). The follow-up time was 84 months. The primary outcome measure was pain intensity, which was assessed via the visual analogue scale (VAS) for pain. The secondary outcomes included wrist function evaluated by the modified Mayo wrist score (MMWS) and patient-rated wrist evaluation (PRWE), grip strength, wrist range of motion (ROM), and radiographic parameters such as ulnar variance, the carpal height ratio (CHR), the carpal ulnar distance (CUD), and the radioscaphoid (RS) angle. The union rate, time to union, time to return to work, and incidence of postoperative complications were also recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups demonstrated significant postoperative improvement in pain (VAS pain score,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). At 84 months, the preservation group achieved superior pain control, with a lower mean VAS score (5 versus 12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). The preservation group also maintained a greater CUD (30\u00a0mm versus 23\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and exhibited later onset of degenerative changes. MMWS improved from 49 to 73 in the preservation group and from 48 to 72 in the excision group. The PRWE scores decreased from 69 to 21 in the preservation group and from 67 to 24 in the excision group. The final grip strength reached 88% of that of the contralateral side in the preservation group and 84% in the excision group, with no significant difference in ROM. The union rates were 93% for preservation and 91% for excision. The excision group presented higher rates of degenerative changes (16 versus 8 cases) and nonunion (2 versus 1). No major differences were found in the infection rate, sympathetic reflex dystrophy, or return to work.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SC arthrodesis provides reliable long-term pain relief in patients with stage IIIB Kienb\u00f6ck\u2019s disease. Lunate preservation provides superior pain control and carpal alignment, reduces degenerative sequelae, and is recommended where feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-025-06147-6","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T13:02:58Z","timestamp":1766062978000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prospective comparative study of scaphocapitate arthrodesis with and without lunate excision for stage IIIB Kienb\u00f6ck\u2019s disease"],"prefix":"10.1007","volume":"146","author":[{"given":"Galal","family":"Hegazy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Seddik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashed","family":"El-Sadek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Gamal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsayed","family":"Shaheen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Alnahas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahem","family":"El-Sebaey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulhamid","family":"Elzoghby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Darweash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"6147_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2021.103161","volume":"108","author":"EJ Camus","year":"2022","unstructured":"Camus EJ, Van Overstraeten L (2022) Kienb\u00f6ck\u2019s disease in 2021. Orthop Traumatol Surg Res 108:103161. https:\/\/doi.org\/10.1016\/j.otsr.2021.103161","journal-title":"Orthop Traumatol Surg Res"},{"key":"6147_CR2","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1055\/s-0036-1593734","volume":"6","author":"DM Lichtman","year":"2017","unstructured":"Lichtman DM, Pientka WFII, Bain GI (2017) Kienb\u00f6ck disease: a new algorithm for the 21st century. J Wrist Surg 6:2\u201310. https:\/\/doi.org\/10.1055\/s-0036-1593734","journal-title":"J Wrist Surg"},{"key":"6147_CR3","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1055\/s-0036-1583755","volume":"5","author":"GI Bain","year":"2016","unstructured":"Bain GI, MacLean SB, Yeo CJ et al (2016) The etiology and pathogenesis of Kienb\u00f6ck disease. J Wrist Surg 5:248\u2013254. https:\/\/doi.org\/10.1055\/s-0036-1583755","journal-title":"J Wrist Surg"},{"key":"6147_CR4","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1053\/jhsu.2003.50035","volume":"28","author":"CA Goldfarb","year":"2003","unstructured":"Goldfarb CA, Hsu J, Gelberman RH et al (2003) The Lichtman classification for Kienb\u00f6ck\u2019s disease: an assessment of reliability. J Hand Surg Am 28:74\u201380. https:\/\/doi.org\/10.1053\/jhsu.2003.50035","journal-title":"J Hand Surg Am"},{"key":"6147_CR5","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1097\/00130911-200603000-00003","volume":"10","author":"GI Bain","year":"2006","unstructured":"Bain GI, Begg M (2006) Arthroscopic assessment and classification of Kienb\u00f6ck\u2019s disease. Tech Hand Up Extrem Surg 10:8\u201313. https:\/\/doi.org\/10.1097\/00130911-200603000-00003","journal-title":"Tech Hand Up Extrem Surg"},{"key":"6147_CR6","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1097\/BTH.0b013e3182492e9e","volume":"16","author":"EJ Camus","year":"2012","unstructured":"Camus EJ, Van Overstraeten L (2012) Surgical technique of a radial wedge \u201ccamembert\u201d osteotomy in Kienb\u00f6ck disease. Tech Hand Up Extrem Surg 16:75\u201379. https:\/\/doi.org\/10.1097\/BTH.0b013e3182492e9e","journal-title":"Tech Hand Up Extrem Surg"},{"key":"6147_CR7","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1302\/0301-620X.90B2.20112","volume":"90","author":"F Schuind","year":"2008","unstructured":"Schuind F, Eslami S, Ledoux P (2008) Kienb\u00f6ck\u2019s disease. J Bone Joint Surg Br 90:133\u2013139. https:\/\/doi.org\/10.1302\/0301-620X.90B2.20112","journal-title":"J Bone Joint Surg Br"},{"key":"6147_CR8","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.jhsg.2023.03.014","volume":"5","author":"F Bouri","year":"2023","unstructured":"Bouri F, Hantouly AT, Alzobi O et al (2023) Clinical and radiological outcomes of scaphocapitate fusion in Kienb\u00f6ck disease: a systematic review and meta-analysis. J Hand Surg Glob Online 5:435\u2013444. https:\/\/doi.org\/10.1016\/j.jhsg.2023.03.014","journal-title":"J Hand Surg Glob Online"},{"key":"6147_CR9","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1177\/1753193417739247","volume":"43","author":"A Charre","year":"2018","unstructured":"Charre A, Delclaux S, Apredoai C et al (2018) Results of scaphocapitate arthrodesis with lunate excision in advanced Kienb\u00f6ck disease at 10.7-year mean follow-up. Journal of Hand Surgery (European Volume) 43:362\u2013368. https:\/\/doi.org\/10.1177\/1753193417739247","journal-title":"Journal of Hand Surgery (European Volume)"},{"key":"6147_CR10","doi-asserted-by":"publisher","first-page":"448","DOI":"10.4055\/cios23167","volume":"16","author":"IH Koh","year":"2024","unstructured":"Koh IH, Kim HS, Kim SH et al (2024) Examining the efficacy of arthroscopic scaphocapitate arthrodesis for advanced Kienb\u00f6ck\u2019s disease: clinical and radiological outcomes. Clin Orthop Surg 16:448\u2013454. https:\/\/doi.org\/10.4055\/cios23167","journal-title":"Clin Orthop Surg"},{"key":"6147_CR11","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.hansur.2020.01.002","volume":"39","author":"S Collon","year":"2020","unstructured":"Collon S, Tham SKY, McCombe D et al (2020) Scaphocapitate fusion for the treatment of Lichtman stage III Kienb\u00f6ck\u2019s disease: results of a single-center study with literature review. Hand Surg Rehabil 39:201\u2013206. https:\/\/doi.org\/10.1016\/j.hansur.2020.01.002","journal-title":"Hand Surg Rehabil"},{"key":"6147_CR12","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1097\/BTH.0b013e31827f452a","volume":"17","author":"X Mir","year":"2013","unstructured":"Mir X, Barrera-Ochoa S, Lluch A et al (2013) New surgical approach to advanced Kienb\u00f6ck disease: lunate replacement with pedicled vascularized scaphoid graft and radioscaphoidal partial arthrodesis. Tech Hand Up Extrem Surg 17:72\u201379. https:\/\/doi.org\/10.1097\/BTH.0b013e31827f452a","journal-title":"Tech Hand Up Extrem Surg"},{"key":"6147_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2022.101854","volume":"28","author":"A Meena","year":"2022","unstructured":"Meena A, Shaina S, Saikia SS et al (2022) Management of type 3 Kienb\u00f6ck\u2019s disease in manual workers by scaphocapitate fusion with minimum 7-year follow-up. J Clin Orthop Trauma 28:101854. https:\/\/doi.org\/10.1016\/j.jcot.2022.101854","journal-title":"J Clin Orthop Trauma"},{"key":"6147_CR14","doi-asserted-by":"publisher","first-page":"3875","DOI":"10.1007\/s00402-024-05423-1","volume":"144","author":"G Hegazy","year":"2024","unstructured":"Hegazy G, Fouaad AA, El-Sadek RE et al (2024) Scaphocapitate arthrodesis with lunate preservation for Kienb\u00f6ck\u2019s disease: prospective outcomes study. Arch Orthop Trauma Surg 144:3875\u20133884. https:\/\/doi.org\/10.1007\/s00402-024-05423-1","journal-title":"Arch Orthop Trauma Surg"},{"key":"6147_CR15","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000006205","volume":"12","author":"P Deptula","year":"2024","unstructured":"Deptula P, McCullough M, Brown T et al (2024) Scaphocapitate arthrodesis for wrist deformities: a systematic review. Plast Reconstr Surg Glob Open 12:e6205. https:\/\/doi.org\/10.1097\/GOX.0000000000006205","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"6147_CR16","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1016\/j.jhsa.2014.12.013","volume":"40","author":"PC Rhee","year":"2015","unstructured":"Rhee PC, Lin IC, Moran SL et al (2015) Scaphocapitate arthrodesis for Kienb\u00f6ck disease. J Hand Surg Am 40:745\u2013751. https:\/\/doi.org\/10.1016\/j.jhsa.2014.12.013","journal-title":"J Hand Surg Am"},{"key":"6147_CR17","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1093\/bja\/aew466","volume":"118","author":"PS Myles","year":"2017","unstructured":"Myles PS, Myles DB, Galagher W et al (2017) Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state. Br J Anaesth 118:424\u2013429. https:\/\/doi.org\/10.1093\/bja\/aew466","journal-title":"Br J Anaesth"},{"key":"6147_CR18","doi-asserted-by":"publisher","first-page":"e58047","DOI":"10.7759\/cureus.58047","volume":"16","author":"\u00d6F \u00d6z\u00e7elep","year":"2024","unstructured":"\u00d6z\u00e7elep \u00d6F, Yavuzer MG, Tunali AN (2024) The validity and reliability of a smartphone application for measuring wrist and metacarpophalangeal joint motion. Cureus 16:e58047. https:\/\/doi.org\/10.7759\/cureus.58047","journal-title":"Cureus"},{"key":"6147_CR19","doi-asserted-by":"publisher","first-page":"2473","DOI":"10.1016\/j.clnu.2022.09.006","volume":"41","author":"R N\u00fa\u00f1ez-Cort\u00e9s","year":"2022","unstructured":"N\u00fa\u00f1ez-Cort\u00e9s R, Cruz BDP, Gallardo-G\u00f3mez D et al (2022) Handgrip strength measurement protocols for all-cause and cause-specific mortality outcomes in more than 3\u00a0million participants: a systematic review and meta-regression analysis. Clin Nutr 41:2473\u20132489. https:\/\/doi.org\/10.1016\/j.clnu.2022.09.006","journal-title":"Clin Nutr"},{"key":"6147_CR20","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1055\/s-0042-1758762","volume":"11","author":"T Nakamura","year":"2022","unstructured":"Nakamura T (2022) Scoring systems in the wrist, forearm, and elbow field. J Wrist Surg 11:473. https:\/\/doi.org\/10.1055\/s-0042-1758762","journal-title":"J Wrist Surg"},{"key":"6147_CR21","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1302\/2046-3758.71.BJR-2017-0081.R1","volume":"7","author":"YV Kleinlugtenbelt","year":"2018","unstructured":"Kleinlugtenbelt YV, Krol RG, Bhandari M et al (2018) Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable? Bone Joint Res 7:36\u201345. https:\/\/doi.org\/10.1302\/2046-3758.71.BJR-2017-0081.R1","journal-title":"Bone Joint Res"},{"key":"6147_CR22","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1177\/17531934231153966","volume":"48","author":"J Luitjens","year":"2023","unstructured":"Luitjens J, Goller SS, Schmitt R et al (2023) Diagnostic performance of traditional radiographic indices in detection of carpal collapse in Kienb\u00f6ck\u2019s disease. Journal of Hand Surgery (European Volume) 48:619\u2013624. https:\/\/doi.org\/10.1177\/17531934231153966","journal-title":"Journal of Hand Surgery (European Volume)"},{"key":"6147_CR23","doi-asserted-by":"publisher","first-page":"1886","DOI":"10.1007\/s11999-016-4732-4","volume":"474","author":"MD Kohn","year":"2016","unstructured":"Kohn MD, Sassoon AA, Fernando ND (2016) Classifications in brief: Kellgren\u2013Lawrence classification of osteoarthritis. Clin Orthop Relat Res 474:1886\u20131893. https:\/\/doi.org\/10.1007\/s11999-016-4732-4","journal-title":"Clin Orthop Relat Res"},{"key":"6147_CR24","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1177\/1753193413496177","volume":"39","author":"M Luegmair","year":"2014","unstructured":"Luegmair M, Saffar P (2014) Scaphocapitate arthrodesis for treatment of late-stage Kienb\u00f6ck disease. J Hand Surg Eur 39:416\u2013422. https:\/\/doi.org\/10.1177\/1753193413496177","journal-title":"J Hand Surg Eur"},{"key":"6147_CR25","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/s00402-025-05783-2","volume":"145","author":"A Elshahhat","year":"2025","unstructured":"Elshahhat A, Nour K, Abed Y (2025) Scaphocapitate fusion in stage III Kienb\u00f6ck\u2019s disease: effects of lunarectomy on postoperative pain and function. Arch Orthop Trauma Surg 145:174. https:\/\/doi.org\/10.1007\/s00402-025-05783-2","journal-title":"Arch Orthop Trauma Surg"},{"key":"6147_CR26","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1007\/s00264-025-06458-8","volume":"49","author":"AA Fouaad","year":"2025","unstructured":"Fouaad AA, Hegazy G, Alnahas M et al (2025) Lunate bone excision and scaphocapitate arthrodesis in late stages of Kienb\u00f6ck\u2019s disease: a long-term prospective study. Int Orthop 49:1143\u20131152. https:\/\/doi.org\/10.1007\/s00264-025-06458-8","journal-title":"Int Orthop"},{"key":"6147_CR27","doi-asserted-by":"publisher","first-page":"299","DOI":"10.4103\/eoj.eoj_57_24","volume":"59","author":"MA Romeih","year":"2024","unstructured":"Romeih MA (2024) Scaphocapitate arthrodesis in late stages of Kienb\u00f6ck\u2019s disease. Egypt Orthop J 59:299\u2013305","journal-title":"Egypt Orthop J"},{"key":"6147_CR28","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/s00402-025-05999-2","volume":"145","author":"Y Kahve","year":"2025","unstructured":"Kahve Y, Gurhan U, Unal KO et al (2025) Four-corner arthrodesis in SNAC wrist: biomechanical and functional comparison of two fixation techniques. Arch Orthop Trauma Surg 145:387. https:\/\/doi.org\/10.1007\/s00402-025-05999-2","journal-title":"Arch Orthop Trauma Surg"},{"key":"6147_CR29","doi-asserted-by":"publisher","first-page":"6469","DOI":"10.1007\/s00402-023-04938-3","volume":"143","author":"C Knie","year":"2023","unstructured":"Knie C, Van Schoonhoven J (2023) Long-term results after total wrist fusion. Arch Orthop Trauma Surg 143:6469\u20136475. https:\/\/doi.org\/10.1007\/s00402-023-04938-3","journal-title":"Arch Orthop Trauma Surg"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-025-06147-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-025-06147-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-025-06147-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T13:03:00Z","timestamp":1766062980000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-025-06147-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,18]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6147"],"URL":"https:\/\/doi.org\/10.1007\/s00402-025-06147-6","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,18]]},"assertion":[{"value":"2 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The authors affirm that participants provided informed consent for publication of the data and images in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"12"}}