Kienböck's disease is a rare idiopathic pathology that affects the blood supply to the lunate bone, causing avascular necrosis and, consequently, abnormal mobility of the carpal bones. In this post we talk about Kienböck disease, its symptoms, causes, diagnosis and treatment. Stay reading!
What is Kiënbock disease?
Kiënbock disease, also known such as avascular necrosis of the lunate or lunatomalacia of the lunate It is a rare disease, of still unknown cause, so that it causes isolated cell death of the semilunar bone of the carpus, which is located between the scaphoid and the pyramidal bone, due to the lack of blood supply, thus causing certain morphological alterations of the bone.
Lunatomalacia of the lunate is more common in the dominant hand in men between 20 and 45 years old, generally in those who work with heavy loads on a daily basis.
Kienböck's disease is bilateral in 10% of cases and was described by the Viennese radiologist Robert Kiënbock in 1910.
Symptoms of lunatemalacia of the lunate
In lunatomalacia of the lunate it is very common to find patients who begin with pain that gradually appears in the wrist, a decrease in its function, as well as a decrease in the pressure force of the wrist to a variable degree.
Another of the main reasons for visiting the specialist is inflammation of the back of the wrist, which generally worsens when performing certain physical activities that involve this bone.
Causes of Kiënbock disease
The cause of Kiënbock's disease is unknown, but there are several factors that influence its appearance, including the following:
- Work and occupation factor, depending on the position you hold and the wrist movements you make, as well as the weight it has to support.
- Genetic factors.
- Vascular factors, due to a precarious blood supply to the lunate bone.
- Biomechanical factors such as negative ulnar variance (when the ulna is shorter than the radius) and the decrease in the normal radial inclination.
- Repetitive trauma to the wrist bone. In more than 80% of cases, cases have been observed in which there is a history of trauma.
Diagnosis and treatment of Kiënbock disease
In any case, It is recommended to go to a wrist specialist so that, through a complete study of the area, you can determine what pathology it is and bring the symptoms closer to the best treatment available in the field of medicine.
Thanks to the newest techniques in wrist surgery, patients have multiple options that are effective both for their recovery and the surgical and pre-operative procedure.
Diagnosis of avascular necrosis of the lunate bone
First of all, the diagnosis is based on a clinical study of the patient's symptoms. With complementary tests such as radiography, magnetic resonance imaging (MRI) or computed tomography (CT), this disease can be confirmed.
An accurate diagnosis, based on the experience of professionals and supported by medical tests, will be the basis for an efficient recovery of the patient.
How to treat wrist pain due to Kiënbock disease
The treatment of Kienbock disease It will depend, first of all, on the severity and state of the pathology.. In the first instance, wrist immobilization treatment is recommended. Studies have shown that treating this disease with non-surgical methods have not been successful, having a wrist splint can relieve pain in very mild cases and can be very beneficial for patients. The administration of anti-inflammatory drugs combined with analgesics can help alleviate the patient's pain.
Thus, in the most advanced cases, surgery will be chosen. It will be the specialist who determines the most appropriate treatment for each patient, explaining the risks and benefits of each of the options.
At Elgeadi Traumatology we have more than 10 years of experience in performing hand and wrist arthroscopy, a very new technique in the medical field. Through a small incision in the patient's skin, the expert introduces an arthroscopic camera that allows visualization of the structures found around the wrist.
Do you suffer from a traumatic wrist injury? Come meet our team of traumatologists experts in advanced wrist surgery in Madrid, we will study your case and determine the most appropriate treatment to address your particular situation. If you still don't know us, you can also go directly without an appointment 365 days a year to our emergency service at the Quironsalud San José Hospital, where we will be looking forward to helping you with whatever you need and putting an end to your pain. We advise you on the treatment that your pathology needs and offer the most specialized service in each of the different areas of traumatology.
15 thoughts on “Qué es, causas, síntomas, diagnóstico y tratamiento de la Enfermedad de Kienböck”
Hello, I am writing to you from Uruguay, I am summarizing what is happening to me.
For a year now I have had pain in my wrist after many treatments and diagnoses, just 2 months ago I was diagnosed with Kienbock disease, the doctors here do not have much information, some recommend that I continue surgery, and others recommend shortening the radius, I would be in stage 2.
Because of all this uncertainty I would like to communicate with a specialist and if I have to have surgery I would have no problem going to Spain to have the surgery, I await a response, thank you!
Hello Franco, first of all, good luck. Please contact us via email [email protected] or on the phone (+34) 910 053 900 and so we can follow your query precisely. Tell us that you met us through the blog. See you soon!
Hello, this article is very interesting and clear. I am from Argentina and I have been diagnosed with Kiënbock disease. I'm planning surgery. I wanted to know more about the link between said disease and genetic factors, since many in my family had arm and wrist surgery.
Thank you so much .
Virginia.
Mar del Plata – Argentina
Hello Virginia,
There may be genetic factors that affect it, although they are not yet known exactly. But there is surely a multifactorial etiology, and it would have to be studied specifically in each case.
Thank you very much for your inquiry.
Hello, I am from Argentina, I have a lot of pain in my wrist, so I consulted a wrist and hand specialist and requested an MRI. I have osteochondritis of the lunate. Theoretically it is not a kiembock disease. But I would like to know if osteochondritis can progress to Kiembock disease?
Thank you so much
Hello, good afternoon,
Indeed it could be. But it is necessary to review the MRI images and evaluate the case as well as the causes. You can make an appointment with us by videoconference and send us your tests to view and analyze them with you.
Greetings
Good afternoon from Mexico. I had wrist surgery 5 months ago, vascularization due to Kienbock. I am attending therapy but the recovery is very slow, I can't close my hand to 100%. The doll has movement at a 30%. A lot of limitation and on the sides. What else could I do or how long will it take to fully recover?
Hi Guadalupe,
Many factors intervene in rehabilitation. We recommend that you consult with your specialist to tell you if the rehabilitation is not being correct.
Greetings
Hello, I have been told that I have Kiembock disease. I would like to know if there is any treatment or operation that is definitive and if I will be able to do the same things with that hand that I did before. Thank you
Hi David,
There are several therapeutic options, but it depends on the stage and bone morphology. Ideally, we would review the images and discuss them in a consultation.
You can make an appointment by calling 91 005 39 00.
Greetings
Hello, 8 years ago I had surgery on my right wrist, due to Kienböck's disease, they removed the lunate, pisiform and piriformis, my wrist hurts and they talked to me about placing a prosthesis, I am a dentist and I work with
The right hand, for which I have postponed a lot, I would like to know how I can consult with you, I live in the Dominican Republic. Thank you.
Hello Pura,
Please send us an email to [email protected] to schedule an appointment by video call.
Greetings
Bonjour
Je suis atteinte de la maladie de kienbok stade 2 beaucoup de douleur je porte une atèle h 24 et au travail c est pire la main gonfle enfin bref c est très handicapant j ai été consulted un spécialiste de la main et me dit qu il nya rien à faire and d attendre le stade 4
Hello, I just had an arthroscopy on my wrist and I have stage 3 Kienbock's disease.
I would like to know if there is a solution to this, since here it seems that they say that there is nothing.
Please contact me as I am from Navarra and I would have to travel. Thank you.
Hi David,
There are surgical treatments to relieve semilunar pressure. We would need to see your case and your tests to know what can be done.
You can contact us by calling +34 91 005 39 00.
Greetings