A review of thirty-eight patients with Kienbock's disease indicated that
both delay in diagnosis and prolonged treatment by plaster immobilization
led to progressive collapse of the lunate and an unsatisfactory result in
most instances. Four clinical and roentgenographic stages were identified,
and the results of silicone replacement arthroplasty were correlated with
the preoperative stage after an average follow-up of twenty-seven months.
The results were satisfactory in fourteen of twenty wrists in which the
procedure was performed before collapse of the lunate had occurred. The
importance of early diagnosis and early surgical treatment of this disorder
was emphasized by the findings in this study.