Functional Outcomes after Radial Shortening Osteotomy in Stage IIIA Kienböck's Disease: A Five-Patient Case Series.

Introduction: Kienböck's disease results from compromised lunate vascularity and often affects young individuals performing heavy manual tasks. Radial shortening osteotomy (RSO) is widely used to reduce lunate loading in cases with ulnar-negative variance. Materials and Methods: Five patients diagnosed with Lichtman stage IIIA Kienböck's disease were treated with RSO. All procedures were performed through a volar approach using locking plate fixation. Pain levels, wrist motion, grip strength, modified Mayo scores, and Disabilities of the Arm, Shoulder, and Hand scores were recorded before surgery and at 12-14 months postoperatively. Radiographs were reviewed for ulnar variance correction and any signs of progression. Results: All patients showed meaningful reductions in pain, improved wrist mobility, increased grip strength, and higher functional scores at final follow-up. Mayo scores ranged from 85 to 94. None progressed to advanced stages, and no complications occurred. Conclusion: RSO yielded consistent improvement in symptoms and function while maintaining carpal architecture in this series. Early recognition and timely intervention remain essential for optimal treatment outcomes.