Kienböck's disease a tendency of the implant to smooth the edges of the surrounding bones, thus causing painful pinched nerves when the bones slip out of place. After the lunate is removed, another procedure, "ulnar shortening" can be performed. This relieves pressure on the newly formed wrist joint of the pisiform, hamate and capitate. Depending on the surgeon, the procedure may be performed the same way as the "radial shortening" where a small section is removed, or the entire top of the ulna may be excised. At Stage 4, the lunate has completely disintegrated and the other bones in the wrist have
Carpal bones proximal row (comprising scaphoid, lunate, and triquetrum) articulates with the surfaces of the radius and distal carpal row, and thus constantly adapts to these mobile surfaces. Within the proximal row, each carpal bone has slight independent mobility. For example, the scaphoid contributes to midcarpal stability by articulating distally with the trapezium and the trapezoid. In contrast, the distal row is more rigid as its transverse arch moves with the metacarpals. Biomechanically and clinically, the carpal bones are better conceptualized as three longitudinal columns: In this context the pisiform is regarded as a sesamoid bone embedded in the tendon of the