Kienbock’s Disease is also known as avascular necrosis of the lunate bone. Avascular necrosis is the lack of blood supply to a bone and the lunate is one of eight bones in the wrist which allows for complex movement of the wrist. Bones need good blood supply to remain healthy and without this the bone will eventually die and no longer provide the appropriate support or stability.
According to the American Society for Surgery of the Hand several theories about the cause of Kienbock’s exist, but a single cause cannot be identified. Some of the identified variables include prior wrist trauma, the shape of the lunate bone, pattern of blood supply to this bone and variations in anatomy of the wrist bones.
There is no way to prevent Kienbocks, however early diagnosis is important to prevent progression of the disease which can lead to wrist arthritis and collapse of the wrist.
Some of the common symptoms include, pain, swelling, weakness of grip and stiffness. Much of the pain is found on the back of the wrist (opposite side of the palm). Kienbocks can affect both men and women but is more common in men between 20 and 40 years of age. Diagnosing Kienbocks can be difficult as many other wrist disorders can have similar symptoms. A hand surgeon will be helpful for both diagnosing and planning appropriate treatment.
Treatment will be based on the progression of change found at the lunate bone. In the early stages conservative treatment may be appropriate which will include splint wear, anti- inflammatory medication, and activity modification. The progression of Keinbocks typically leads to further collapse of the bones or advanced arthritis. Talking with a hand surgeon is important to discuss appropriate surgical options and understand outcomes and expectations. Although Keinbocks can be a challenging issue surgical treatment can be successful in restoring function and minimizing pain to allow for an improved quality of life
