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Introduction: Functional results of four surgical techniques to resolve the IIIB-IV Litchman's stage of the Kienböck disease were analyzed. We observed the evolution from 2000 to 2015., Material and Methods: Transversal retrospective study of 33 patients treated with different surgical techniques and evaluated with Quick-DASH scale, dynamometer and EVA., Results: Less functional limitation was found in the patients who underwent the intercarpal fusion with or without neurotomy of the posterior interosseous., Discussion: It was shown that the fact of making a less aggressive surgery is enough to evolve into an increase in symptoms and a decrease in function and strength; therefore, the intercarpal fusion performed at the right time of the natural history of the disease can achieve better results than other methods used previously and endorsed by international associations., Conclusions: The surgical technique of choice in our series to prevent disease progression was the intercarpal fusion and neurotomy of the posterior interosseous nerve.