الفهرس 
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Abstract
ienböck disease is a condition of uncertain etiology that results in osteonecrosis of the carpal lunate. Patient presents with wrist pain, loss of motion, and decreased strength owing to the predictable pattern of lunate fragmentation, carpal instability, and carpal collapse. Management of Kienböck disease ranges from immobilization to a variety of surgical options that include lunate off-loading or joint leveling, lunate revascularization, and salvage procedures guided by the stage of the disease. Limited wrist arthrodesis (LWA), such as scaphotrapeziotrapezoid (STT) or scaphocapitate arthrodesis (SCA) with lunate salvage, can be used for patients with neutral ulnar variance or in more advanced stages. Prospective cohort study was conducted at orthopedic surgery department- Tanta University Hospital 21 patient with late stage Kienbock’s disease underwent scaphocapitate arthrodesis during the period October 2018 – October 2020, There were 6 women and 15 men. Mean age at the time of the intervention was 43 years (range 25 to 60). There were 13 right and 8 left wrists. By Comparison of final results among demographic data we found that there was no statistically significant difference in demographic data regarding final results. By Comparison K between final results among mechanism of injury we found that no statistically significant difference in mechanism of injury regarding final results. By Comparison between final results among associated medical disease we found that there was no statistically significant difference in associated medical disease regarding final results. By Comparison between final results among type of lunate and lichmans class we found that there was no statistically significant difference in type of lunate regarding final results but there was statistically significant increase stage 3A in excellent and increase stage 3B in good results. Analysis of scores among dominant and non-dominant hands showed that there was statistically significant increase between Extension/ flexion arc among dominant and nondominant hands. The QuickDASH score at final follow-up shows that there was statistically significant increase DASH score and time of full union. The visual analogue score (VAS) was 14.10 with range from 0 to 35. We recommend Patients undergoing SCA for Kienböck disease should be counseled regarding the potential for adjacent joint degeneration and persistent pain that may require future procedures. Although lunate excision may lead to progressive radiographic carpal collapse and/or ulnar translocation of the carpus, lunate management (salvage or excision) does not appear to affect clinical outcomes. Scaphocapitate arthrodesis should be considered as a treatment option for wrist salvage in the patient with late stages of Kienbock’s disease. SCA resulted in improved grip strength with correction of carpal alignment in patients with advanced stages of Kienböck disease. Although radiographic carpal collapse and ulnar translocation occurred, patients were not symptomatic. Patients should be counseled that decrease in wrist range of motion will likely occur.