What is Kienböck’s Disease?
Kienböck’s disease is a condition that affects the lunate bone, a small but important carpal bone that is sometimes referred to as the “keystone of the wrist”. Kienböck’s essentially cuts off the blood flow to this bone, causing it to die and break down through a process called avascular necrosis. If undiagnosed or untreated, Kienböck’s can be debilitating and eventually lead to the loss of all motion in the affected wrist.
What Causes Kienböck’s Disease?
While it is not known specifically what causes Kienböck’s there are a number of factors that may predispose a person to suffering from the condition. The most common factor is some sort of trauma to the wrist, which can lead to decreased blood flow to the lunate and other carpal bones. It has also been shown that some people have only one arterial connection to the lunate, so that if even one artery were pinched, the blood flow would be decreased enough to have a marked affect on the lunate.
What are symptoms of Kienböck’s Disease?
Kienböck’s is often difficult to diagnose in the early stages, but as the disease progresses, it is marked by pain and swelling in the wrist, stiffness and limited range of motion, pain and difficulty turning the wrist, tenderness over the central wrist (where the lunate is located) and a lessening of grip strength.
How to diagnose Kienböck’s Disease.
In the early stages, as mentioned, it is difficult to detect Kienböck’s externally or with X-Rays, but it can be definitively identified by the use of MRI. If the condition is not caught in time, it can be picked up at later stages on X-rays as the bone begins to harden and lose its mineral content.
Non-surgical treatment of Kienböck’s Disease.
In some cases, if the progression of the disease is caught early enough, it may be possible to avoid surgery, and simply splint and cast the wrist for several weeks. Splinting and resting the wrist may restore blood flow to the lunate bone, and the disease’s effects may be averted.
Surgical treatment of Kienböck’s Disease.
Surgery is by far the preferred and necessary option in most cases of Kienböck’s disease. Depending on how advanced the disease is when it is detected there are various options as to which type of surgery is necessary. In early stages one forearm bone can be shortened to reduce pressure on the lunate allowing it to heal. As the disease progresses and the bone break apart traumatic arthritis develops. In the more advanced stages the lunate is actually removed and either part of the wrist is fused restricting some movement or the complete wrist is fused stiff.
How can Dr. Knight help you with Kienböck’s Disease?
When it comes to rare and complex wrist issues like Kienböck’s, it is important to find a surgeon who is well-versed in their treatment and who has seen many cases. Dr. Knight is one such surgeon, and he will bring his expertise to bear in your case, which will, no doubt, lead to the restoration of function in your hand and wrist.
Kienbock’s Disease Animation Video
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