Kienbock Disease (Avascular Necrosis of the Lunate)

Kienbock Disease (Avascular Necrosis of the Lunate)



Description


Kienbock disease is characterized by death of one of the bones of the hand and wrist, the lunate bone, from loss of blood supply. This is thought to be related to repetitive microtrauma, causing interruption of the blood supply to the bone.



Common signs and symptoms



• Wrist pain and tenderness

• Stiffness and loss of motion at the wrist

• Tenderness and swelling in the wrist (occasionally)

• Loss of grip strength

• Swelling in the wrist (uncommon)


Causes


The cause of this problem is controversial. It is thought to be related to microtrauma or repetitive stress to the wrist. It is felt that the blood supply to the lunate is somewhat tenuous, making it susceptible to interruption and loss of blood supply and bone death. Falling on an outstretched hand may or may not be associated. An ulna bone that is shorter than the radius at the wrist, called negative ulnar variance, results in greater force transmission across the wrist to the lunate, possibly affecting its blood supply.



Factors that increase risk



• A long radius bone

• Repeated wrist injury

• Dominant wrist

• Age between 20 and 40 years


Preventive measures


No preventive measures are known.



Expected outcome


The outcome of the disease depends on how advanced the disease process is. Nearly always, immobilization and usually surgery are required. Return to sports is variable.

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Jul 18, 2016 | Posted by in SPORT MEDICINE | Comments Off on Kienbock Disease (Avascular Necrosis of the Lunate)

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