Introduction:

Functional results of four surgical techniques to resolve the IIIB-IV Litchman`s stage of the Kienböck disease were analyzed. We observed the evolution from 2000 to 2015.

aterial and methods:

Transversal retrospective study of 33 patients treated with different surgical techniques and evaluated with Quick-DASH scale, dynamometer and EVA.

Results:

Less functional limitation was found in the patients who underwent the intercarpal fusion with or without neurotomy of the posterior interosseous.

Discussion:

It was shown that the fact of making a less aggressive surgery is enough to evolve into an increase in symptoms and a decrease in function and strength; therefore, the intercarpal fusion performed at the right time of the natural history of the disease can achieve better results than other methods used previously and endorsed by international associations.

Conclusions:

The surgical technique of choice in our series to prevent disease progression was the intercarpal fusion and neurotomy of the posterior interosseous nerve.