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.

Causes:

  • 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.

Symptoms:

  • 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

Treatment:

  • 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.

Prevention:

  • 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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