Kienbock’s disease is caused by the loss of blood supply to the lunate. The lunate is one of the eight small bones that make up the “carpal bones” in the wrist.
There are two rows of bones in the wrist: the proximal row, located closer to the forearm, and the distal row, which is closer to the fingers. The lunate bone is in the center of the proximal row. It is next to the scaphoid bone, which spans the two rows.
There is probably no single cause for loss of blood supply to the lunate. The cause of Kienbock’s disease seems to involve multiple factors. These factors include the blood supply (arteries), the blood drainage (veins), and skeletal variations.
Skeletal variations associated with Kienbock’s disease include a shorter length of the ulna, one of the forearm bones, and the shape of the lunate bone itself. There may be some cases that are associated with diseases like gout, sickle cell anemia, and cerebral palsy.
Trauma, either a single event or repeated significant trauma, may affect the blood supply to the lunate. In general, though, Kienbock’s disease is not felt to be related to occupational hazards.
However, the presence of Kienbock’s disease can affect the treatment and prognosis for traumatic events.
Kienbock’s disease treatment depends on the severity and stage of the disease.
In very early stages, the treatment can be as simple as observation or immobilization. For more advanced stages, surgery is usually considered to try to reduce the load on the lunate bone by lengthening, shortening, or fusing various bones in the forearm or wrist.
Sometimes bone grafting or removal of the diseased lunate is performed.
If the disease is very advanced and the relations of the bones from one to the other have markedly deteriorated, complete wrist fusion may be the treatment of choice.
Hand therapy does not change the course of Kienbock’s disease, but it may help to minimize the disability from the problem. Treatment is designed to relieve pain and restore function.
Our hand doctor will advise you of the best treatment options for you, as well as explain the risks, benefits, and side effects of various treatments for Kienbock’s disease.
The results of Kienbock’s disease and its treatment vary considerably depending on the severity of the involvement, as well as whether or not the disease progresses. The disease process and response to treatment will take several months. On occasion, several forms of treatment, and even multiple operations, might be necessary.
If you believe you are experiencing symptoms of Kienbock’s disease, make an appointment to see our hand surgeon in West Bloomfield, Howell, Warren, or Macomb Township.
Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.Jackie S.
I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.Jerry T.
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