Ischemic necrosis of lunate bone, osteonecrosis or Kienböck´s disease was described by Kienböck in 1910. Numerous surgical procedures for this disease had been proposed. These surgical options, that depends of the radiological stage and anatomical risk factors, can be classified into lunate unloading procedures, lunate revascularization, replacement procedures and salvage procedures. These procedures, except the salvage procedures, has been successful in reconstructing and maintaining the height of the carpus, avoiding progression of the disease and with reduction of the pain.
The lunate unloading procedures are surgical treatments that make a radial osteotomy for modify differents anatomical risk factors associated with the osteonecrosis.
Kienbock´s disease in the wrist estages II, IIIA, IIIB or IIIC by Lichtman classification
Pre-radiological stages-Lichtman stage I
Radiocarpal and midcarpal osteoarthrosis, Lichtman stage IV
Kienböck in children: less than 18 years
Adults years greater than 85 years old