title: Does dorsal capsule interposition improve the results of proximal row carpectomy in Kienböck's disease? One year randomized trial.
abstract: BACKGROUND
  Proximal row carpectomy (PRC) is an option as a salvage procedure in late stage Kienböck's disease. In this study, we hypothesize that interposition of a dorsal capsular flap following PRC improves functional outcomes. No comparative study is available to assess whether interposition is effective from the functional perspective. This study aims to determine whether the addition of this procedure may improve functional outcomes at a one year assessment.
  
  
  METHODS
  Thirty adult patients with IIIA and IIIB Lichtman stages, aged 18-54 years, were randomized into two study groups. Fourteen patients were allocated to the "no interposition group" and 16 to the "interposition" group. DASH questionnaire was used to evaluate quality of life. Cooney's system was used to assess pain, functional state, range of motion, and grip strength. Complications were also assessed. Final followup and clinical assessment occurred after 12 months.
  
  
  RESULTS
  After 12 months and no patient losses, outcomes were similar in both groups. DASH scores (41.9 (7.5) vs. 42.9 (12.8), p = 0.79)), Cooney's system (poor results, 0.6 vs. 0.14, p = 0.54), and complications were similar between groups. In conclusion, the inclusion of a dorsal capsular flap does not improve functional outcomes in PRC. Low rates of complications were found in both groups.
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Department of Orthopaedics and Traumatology, SP, Brazil.
authors.forename: Walter Yoshinori
authors.initials: WY
authors.lastname: Fukushima
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Department of Orthopaedics and Traumatology, SP, Brazil.
authors.forename: Vinícius Ynoe
authors.initials: VY
authors.lastname: de Moraes
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Department of Orthopaedics and Traumatology, SP, Brazil.
authors.forename: Fernado Travaglini
authors.initials: FT
authors.lastname: Penteado
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Department of Orthopaedics and Traumatology, SP, Brazil.
authors.forename: Flávio
authors.initials: F
authors.lastname: Faloppa
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Department of Orthopaedics and Traumatology, SP, Brazil.
authors.forename: João Baptista Gomes
authors.initials: JB
authors.lastname: Dos Santos