Kienböck's disease is probably caused by microfractures or stress fractures developing within the lunate. In about 32% of the population, the vascular pattern to the lunate is such that after fracture they are vulnerable to a secondary aseptic necrosis of the lunate. The high incidence of Kienböck's disease in patients with an ulnar minus variant wrist may be explained by an increased stress on the lunate in dorsiflexion and ulnar deviation. This study is a 5- to 10-year follow-up of patients with early stages of Kienböck's disease and ulnar minus variant treated by radial shortening procedures. Eleven of the 12 patients were satisfied with their treatment and showed functional improvement. These patients returned to their normal activities. Grip strength was satisfactory, and range of motion improved following surgery.