Four main stages. Stage1; No significant radiographic changes, Stage2: relative radio density in the lunate with out collapse. Stage3: some degree of fragmentation and collapse widening of space between scaphoid and triquetrum. Stage4: complete collapse of radio carpal and inter carpal joints.
Ulnar negative wrist: Options include radial shortening, or ulnar lengthening. If ulnar positive then radial lengthening or ulnar shortening can be done. Other procedures include scaphotrapezial or schaphocapitate arthodesis. replacement of lunate also can be tried.