Kienbock’s Disease: Orthopedic Treatment In Frisco

by Administrator 25. April 2016 10:47

The wrist is made up of eight carpal bones-one of which is the lunate bone. Any damage or loss of blood supply to this bone is termed as Kienbock’s Disease. Also known as Lunatomalacia or Avascular Necrosis of the Lunate, the condition is characterized by severe pain, swelling and difficulty in wrist movement. In severe stages, it may affect the adjacent bones within the wrist joint. It can be categorized into four stages:

  • Stage 1 – At this stage, there may be a disruption in blood supply to the lunate. However, an X-ray may not show any signs of damage.
  • Stage 2 – The bone may become hard and dense, a condition known as Sclerosis. X-ray results may reveal the damage caused to the bone. 
  • Stage 3 – In this, the affected bone may begin to collapse and break into several pieces, causing the surrounding bones to dislocate.
  • Stage 4 – The lunate is completely collapsed during this stage and the other wrist bones may also weaken, leading to the development of Arthritis.


  • Loss of arterial supply to the lunate
  • Damage to the venous drainage of the lunate
  • Short length of the adjoining ulnar bone
  • Trauma to the wrist, such as during a car accident
  • Repetitive stress
  • Medical conditions such as Sickel Cell Anemia, Gout, Cerebral Palsy, Lupus etc.


  • Swollen wrist
  • Pain
  • Stiffness
  • Clicking sound in the wrist
  • Weakening grip strength
  • Tenderness to touch
  • Restricted range of motion, particularly during upward movement of the wrist


  • The doctor may recommend wearing a brace or splint to restrict the movement of the wrist.
  • Giving complete rest to the wrist and avoiding any movements that may trigger pain.
  • Anti-inflammatory medications may be prescribed to ease pain and reduce swelling.

Patients with Stage 4 Kienbock’s Disease may require surgery. The wrist specialist may recommend any of the following procedures:

  • Revascularization: This involves removing a portion of a bone along with the blood vessels and inserting into the lunate to augment or restore blood supply.
  • Joint Leveling: It may be performed if there is a difference in lengths of the forearm bones. The surgeon may either insert a bone graft to increase the length or remove a section of the bone to shorten it. 
  • Fusion: Joining the surrounding wrist bones, either partially or completely, may help to decrease pressure on the lunate.
  • Arthroplasty: In this procedure, the lunate is replaced with an artificial implant to help the patient find relief from the symptoms.


  • Avoid trauma to the wrist
  • Seek proper and timely of the wrist conditions that may cause Kienbock’s Disease, such as Septic Emboli or Sickle Cell Disease.

Dr. Knoll is a Frisco, TX based hand and wrist surgeon providing comprehensive treatment for Kienbock’s Disease. To schedule an appointment, you can call at (214) 618 – 5502.

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De Quervain’s Tendonitis: Orthopedic Carrollton

by Administrator 26. October 2015 14:07

De Quervain’s Tendonitis, also known as Washerwoman's Sprain is a medical condition which involves inflammation of the tendons around the base of the thumb. These tendons run through a tunnel made up of soft tissues which swells and narrows the tunnel. Swelling of the tendons may lead to pain while doing any hand or wrist movement.  People involved in activities that require repetitive hand and wrist movement have more chances to develop this condition.


  • Overuse of the thumb
  • High-impact blow to the thumb
  • Repetitive clutching
  • Rheumatoid Arthritis
  • Racquet sports
  • Activities such as gardening
  • Women can get it just after pregnancy


  • Pain along the back of the thumb
  • Pain that resonates from the thumb up to the forearm
  • Difficulty in moving the thumb
  • Hurting sensation, particularly when grasping things
  • Inflammation and pain side of the wrist


An orthopedic doctor may conduct Finkelstein test to confirm the presence of De Quervain. He may ask the patient to make a fist with thumb placed in his palm. While turning the wrist outwards, the tendons get pulled and stretched. If this test is painful then a patient suffers from this condition.


  • Splint: A doctor may advise to wear a splint to prevent thumb and wrist movement. All activities that worsen this condition have to be completely stopped.
  • Ice pack: Ice packs can be applied to the affected area at regular intervals as it may help in eliminating pain and swelling.
  • Medication: Anti-inflammatory medicines such as ibuprofen or naproxen, as prescribed by doctor, can be administered to reduce tenderness. Steroids can also be given if the pain is unbearable.
  • Avoiding strenuous activities: A doctor may suggest reducing the activities that cause pain and swelling as it may relieve the symptoms.
  • Corticosteroids: Corticosteroids injection may be recommended by a doctor to provide relief from pain and swelling.
  • Exercise: Certain exercises may be recommended by the doctor so as to strengthen the thumb and wrist. These help in the healing process by reducing pain and improving health of the patient.
  • Surgery: When a patient does not respond to non-surgical treatments, the doctor may recommend surgery.

If you are suffering from De Quervain’s Tendonits, consult Dr. Knoll. The orthopedic doctor specializes in treating a wide range of wrist and hand conditions. To schedule an appointment, call at (214) 618 -5502 or visit 5757 Warren Parkway Suite 180, Frisco, Texas 75034.

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Arthritis Of The Hand

by Administrator 20. November 2013 13:30

Arthritis is an autoimmune disease that is associated with chronic inflammation and pain the affected joint. The disease can affect people of all ages and is characterized by alternate periods of flares and remissions. Being a chronic disease, it usually lasts for years, with long periods when the patient experiences no symptoms. In some cases, arthritis of the hand can result in a damage of the cartilage, bones, and ligaments, and ultimately deformity of the joints. This form of arthritis can be severely debilitating, causing difficulty in performing everyday activities.

Arthritis of the hand or the wrist can have multiple causes as listed below:

  • It is believed that some people can be genetically predisposed to getting arthritis.
  • Being an autoimmune disorder, it can be triggered by certain infections that cause the activation of the immune system.
  • Worn out or damaged cartilage- This could be caused by disease or trauma, and results in a limited range of motion in the joint.
  • The excessive production of synovial fluid in the body as an attempt to make up for the lost cartilage results in inflammation.
  • It is important to visit an orthopedic doctor if you experience pain or inflammation in the hand. If left untreated, the bones eventually lose their shape, resulting in further limiting of motion.

The symptoms of arthritis of the hand come and go depending on the extent of tissue inflammation. Some of the major symptoms of arthritis include:

  • Fatigue
  • Loss of energy
  • Lack of appetite
  • Low grade fever
  • Muscle and joint aches
  • Stiffness in the knuckles, especially upon waking up in the morning
  • Redness, swelling, warmth, and tenderness around the joints in the hands during periods of flares.


  • Non-surgical treatment involves the use of anti-inflammatory drugs, steroid injections, and splinting.
  • This treatment cannot reverse the joint damage that has already occurred, but can help to treat symptoms.
  • When these options fail to provide relief, it is advisable to visit a hand surgeon, who can perform surgery to provide long-term pain relief and help restore function. It is important to visit an experienced surgeon in Frisco, who shall carefully evaluate your case before suggesting the most suitable surgical option for you.
  • Once the surgery is performed, you shall be referred to a trained hand therapist who will help to maximize your post-operative recovery.

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