الفهرس 
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Abstract
Avascular necrosis of the lunate bone was firstly reported by Peste in 1843,but it wasn’t widely recognized until 1910, when an Austrian radiologist, Robert Kienböck , published his classic description of lunate malacia and reported a series of 16 cases of traumatic malacia of the lunate.
kienbock’s disease is a rare disease which may be precipitated by vascular and skeletal variation combined with trauma or repetitive loading, It affect significantly the function of the wrist and the hand even before fragmentation of Lunate bone and occurrence of osteoarthritis wrist.
Clinically the disease presented with pain which may increased by activities, limitation of movement ,edema and tenderness at dorsum of wrist and there is many investigation help in diagnosis such as X rays, Tomography, bone scintigraphy, CT scan , MRI , wrist arthroscopy.
Lichtman et al., 1977, described a clinical and radiographic classification for Kienböck’s disease which guide to the selection of line of treatment, and comparing the results of different treatment regimens.
Concerning the management of early stages of Kienbock’s disease cases which associated with abnormal ulnar variance, radial shortening or ulnar lengthening are widely accepted and applied as an efficient decompressive way for these cases , its usage at the rare cases of normal ulnar variance modifies the wrist biomechanics.
Almquist in 1986 described an alternative procedure for such cases, a capitate shortening osteotomy to reduce the lunate pressure associated with capitate-hamate fusion.Later, Almquist reported satisfying clinical results for a series of 17 cases treated with the capitate-shortening technique associated or not with capitate-hamate fusion.
The aim of this study is to evaluate the results of treatment of cases of Kienbock’s disease associated with neutral or positive ulnar variance by capitate shortening according to clinical outcome ,radiologically and by MRI studies.
The study was carried out from November 2011 to February 2013 in the department of Orthopedic surgery and traumatology in Minia University Hospital. It included 12 cases of Kienboock’s disease at stage II and IIIA associated with neutral ulnar variance. The cases were followed up for one year & the final results are 4 cases(33.33%) excellent , 4 cases (33.33%) good , 2 cases(16.66%) fair , 2 cases(16.66%) poor.