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Gradual fibular transfer by Ilizarov external fixator is a reliable technique in management of post-traumatic and post-infection large tibial bone defects with good clinical outcome, and with few complications.

Background: Capitate shortening is the best decompression procedure in the management of Kienböck’s disease in patients with ulnar neutral or positive variance, although carpal collapse develops inevitably. The current study was to report our experience in partial capitate shortening osteotomy as an alternative procedure. Methods: This was a prospective study of 20 patients with Lichtman stage II and IIIa Kienböck’s disease managed by partial capitate shortening osteotomy. Results: At final follow-up (average 36.5 mo), visual analog pain scores improved significantly postoperatively to 3.3. Flexion and extension improved from 62% (±17%) and 52% (±21%) preoperatively to 63% (±13%) and 68% (±13) postoperatively, respectively. The power grip improved significantly from 49% (±16%) to 63% (±12%) postoperatively. The average quick Disability of the Arm Shoulder and Hand Score improved from 60.8(±13.8) to 38.3(±13.9) postoperatively. Conclusions: Partial capitate shortening is a simple and effective procedure for the management of ulnar neutral or ulnar positive Kienböck’s disease before the onset of radiocarpal arthrosis without violation of scaphocapitate joint thus avoiding carpal collapse that follows complete capitate shortening. Type of Study/Level of Evidence: Therapeutic IV.