Advances in diagnosis and treatment is edited by david m. Kienbock s disease is a rare, debilitating disease process that can lead to chronic pain and dysfunction. Kienbocks disease musculoskeletal medicine for medical. I have kienbock s disease ama kienbock s disease is avascular necrosis of the lunate bone. Kienbocks disease include a shorter length of the ulna, one of the forearm bones, and the shape of the lunate bone itself see figure 2. Your doctor will ask about your medical history, your lifestyle, and your wrist. Yes, it is inherited on the x chromosome, which means that it is usually but not always worse in males. A condition where interruption of the blood flow to the lunate bone often due to wrist inflammation or injury in the wrist damages it and impairs wrist movement. On physical exam he has tenderness over the dorsal radiocarpal joint. Kienbocks disease can be difficult to diagnose, especially in its early stages when it resembles a wrist sprain. Pdf a case of a 27 years old female with history of pain in left wrists is presented. Pdf kienbocks disease, or osteonecrosis of the lunate, can lead to chronic, debilitating wrist pain. I was wondering if anyone else has been rated for this.
Kienbocks disease ebook pdf free download edited by david m. This tiny bone is one of the eight carpal bones, and is essential for movement and support of the wrist joint. Since most hypotheses have been published in the premedline era, the search was supplemented with additional references of indexed articles. A 43yearold woman with diabetic peripheral neuropathy and a history of remote carpal tunnel release and. This basically means that the lunate bone in my left hand was injured at some point fell on ice 4 years ago and caused a disruption to the blood, over time ki. Affected people may first think they have a sprained wrist and may have experienced trauma to the wrist, which can disrupt the blood flow to the lunate. Loading of the lunate in patients with kienbocks disease and a negative ulnar variance provide the rationale for a radial shortening osteotomy.
If you have problems viewing pdf files, download the latest version of adobe reader. Trauma, either a single event or repeated significant trauma, may affect the blood supply to the lunate. This shifting eventually leads to degenerative changes and osteoarthritis in the joint. It is breakdown of the lunate bone, a carpal bone in the wrist that articulates with the radius in the forearm. New advanced microsurgery saves wrist function for patients with kienbocks disease curtis nationals james higgins, md, becomes first us doctor to perform surgery. He denies systemic symptoms, history of trauma, or recent weight loss. Recent studies gay et al evaluated the use of a simple capitate osteotomy without arthrodesis, through a dorsal medial approach and fixed with staples, in 11 patients with mild forms stage i to iiia, lichtman classification of kienboc. Kienbocks disease is a problem in the wrist caused by the loss of blood supply to the lunate. It is important to get a clear history from the patient and examine the wrist very carefully. Kienbock s disease is a condition characterized by interruption of blood supply to one of the small bones of the hand near the wrist the lunate. Kienbock disease online journal of health and allied. Eventually this collapse can lead to arthritis in the joints nearby.
Kienbock s disease, also known as avascular necrosis of the lunate, occurs when one of the eight small carpal bones in the wrist the lunate bone becomes damaged because its blood supply is lost. Kienbock s disease is a rare and infrequently discussed source of wrist pain that you could definitely encounter in your clinical practice. The extremely painful and debilitating condition, for which there is no known cause, typically affects young male patients in the teenage years or twenties. Progressive pain, without a clear history of acute trauma, is the primary presenting complaint. The can result in part, or all, of the bone very gradually dying and collapsing over time. More detailed information about the symptoms, causes, and treatments of kienbock disease is available below. Initially, the lunate appears to be more radiodense, which is consistent with the radiologic appearance of osteonecrosis. In the journal of hand surgery, avascular necrosis of the lunate is also referred to as. Outcome of kienbocks disease 22 years after distal radius. Kienbocks disease, also known as avascular necrosis of the lunate, is a condition in which the lunate bone, one of eight small bones in the wrist, loses its blood supply, leading to death of the bone. Sometimes the problem can be seen on a simple xray. Anyone is welcome to join this group, we can raise the profile of this odd bone disease.
Kienbocks disease genetic and rare diseases information. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. A magnetic resonance imaging mri scan picks up very early changes in the lunate, even when the xrays are normal, and is the most sensitive test for this condition. Collecting and synthesizing all of the most recent literature on kienbocks disease.
A coronal fracture that splits the lunate into dorsal and volar fragments may. This is a relatively rare condition in which the blood supply of the lunate bone in the wrist is reduced. I have a metal plate in my wrist, and a huge scar, with keloids that is still very painful. It is too rare to be sure, but it appears most cases seem to happen from an incident, with anatomy or medical condition second, medical. Lichtman and gregory ian bain advances in diagnosis and treatment published by springer about the book. Kienbock disease symptoms, diagnosis, treatments and. Preisers disease or idiopathic avascular necrosis of the scaphoid is a rare condition that often presents as vague wrist pain with an insidious onset. The content of the website and databases of the national organization for rare disorders nord is ed and may not be reproduced, copied, downloaded or disseminated, in any way, for any commercial or public purpose, without prior written authorization and approval from nord. Any information contained in this pdf file is automatically generated from digital material. I had never even heard of this disease until a few months ago. Kienbocks disease is a condition characterized by interruption of blood supply to one of the small bones of the hand near the wrist the lunate. It happens when one of the eight small carpal bones in the wrist, the lunate bone, becomes.
Kienbocks disease kd represents the osteonecrosis of the lunate. Indroduction kienbock diseas is an isolated disorder of lunate resulting from vascular compromise to the bone avascular necrosisosteomalacia of lunate dr robert kienbock 1910 he described step wise progression disease from isolated proximal lunate involvement,to fragmentation and collapse of. The lunate is a central bone in the wrist that is important for proper movement and support of the joint figure 1. This first edition textbook of kienbocks disease, published by springer publications, collects and synthesizes. Preiser s disease kienbock disease arthritis research. It causes a variety of symptoms, which can be very severe. Kienbock s disease, or osteonecrosis of the lunate, can lead to chronic, debilitating wrist pain. The condition is named after the viennese radiologist robert kienbock who presented his findings on the disorder in his 1910 publication concerning traumatic malacia of the lunate and its consequences. The classification and treatment of kienbock s disease.
Definition avascular necrosis of the carpal lunate blood supply of the lunate receives supply from both dorsal and palmar surfaces in 80%, but volar surface only in 20% dorsal supply from dorsal radiocarpal arch dorsal intercarpal arch occasionally from d. These surgical methods have some disadvantages, such as large, invasive, and complicated procedures and uncertain. The lunate is one of the eight small bones that make up the carpal bones in the wrist see figure 1. Hello, i was diagnosed with kienbock disease and have just had surgery a few days ago. Kienbock disease is it a disability doctor answers.
Kienbocks disease, is a rare, debilitating condition that can lead to chronic pain and dysfunction. The va keeps trying to call it a ganglion cyst, when its in my records that its kienbocks disease. There are few reports in children and therapeutic recommendations in the literature about this condition. Kienbock s disease occurs when the lunate bone in the wrist suffers damage due to limited blood flow. Learn more of its signs and symptoms, causes and treatment.
Answer to radiologic case study kienbocks disease and scapholunate advanced collapse. As with all bones and tissue, proper functioning is dependent upon a continuous supply of oxygenated blood. New advanced microsurgery saves wrist function for. At this time an etiology has not been elucidated, but there is evidence to suggest that there may. In the late stages of the disease, the bone collapses, shifting the position of other bones in the wrist. There may be some cases that are associated with diseases like gout, sickle cell anemia, and cerebral palsy. In this work, kienbock described an isolated disease of the lunate associated with secondary changes in the other carpal bones.
I was diagnosed with what the orthopedic surgeon said was kienbock s disease. Kienbock disease is the eponym for avascular necrosis of the. Kienbocks disease and scapholunate advanced collapse. Etiologic factors include vascular and skeletal variations combined with trauma or repetitive loading. For language access assistance, contact the ncats public information officer.
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