Kienbock's Disease

A Patient's Guide to Kienbock's Disease

Introduction

Kienbock's disease is a condition in which one of the small bones of the wrist loses its blood supply and dies, causing pain and stiffness with wrist motion. In the late stages of the disease, the bone collapses, shifting the position of other bones in the wrist. This shifting eventually leads to degenerative changes and osteoarthritis in the joint. While the exact cause of this uncommon disease isn't known, a number of treatment options are available.

This guide will help you understand

  • how Kienbock's disease develops
  • how doctors diagnose the condition
  • what treatment options are available

Anatomy

How does the wrist joint work?

The anatomy of the wrist joint is extremely complex, probably the most complex of all the joints in the body. The wrist is actually a collection of many joints and bones. These joints and bones let us use our hands in lots of different ways. The wrist must be extremely mobile to give our hands a full range of motion. At the same time, the wrist must provide the strength for heavy gripping.

The wrist is made of eight separate small bones, called the carpal bones. The lunate is one of these bones.

It is the bone that is affected in patients with Kienbock's disease.

The carpal bones connect the two bones of the forearm, the radius and the ulna, to the bones of the hand. The metacarpal bones are the long bones that lie underneath the palm. The metacarpals attach to the phalanges, which are the bones in the fingers and thumb.

Related Document: A Patient's Guide to Wrist Anatomy

Causes

Why do I have this condition?

Doctors have not determined exactly what causes Kienbock's disease. A number of factors seem to be involved. Usually the patient has injured the wrist. The injury may be a single incident, such as a sprain, or a repetitive trauma. But the injury alone does not seem to cause the disease.

The way that blood vessels supply the lunate is thought to play a role in Kienbock's disease. Some bones in the body simply have fewer blood vessels that bring in blood. The lunate is one of those bones. A bone with a limited blood supply may be more at risk of developing the disease after an injury. The reduced blood supply might be the result of a previous injury to the blood vessels.

Other bones around the lunate may play a role in the disease, too. The length of the ulna, the bone of the forearm on the opposite side of the thumb, may be a factor. When the ulna is shorter than the radius, an imbalance of pressure is created in the wrist joint. Normally, the ulna supports a portion of the force that needs to be transferred from the hand to the forearm. If the ulna is too short, this cannot occur. The lunate is caught between the capitate bone and the radius and must absorb more force when the hand is used for heavy gripping activities. Over time, this extra force may make it more likely for a person to develop Kienbock's disease. Chronic repetitive trauma can lead to damage of the arteries supplying blood to the lunate.

Kienbock's disease is also sometimes found in people with other medical conditions that are known to damage small blood vessels of the body. Whatever the cause, the lunate bone develops a condition called osteonecrosis alink_delimiter_one_string . In osteonecrosis, the bone dies, usually because it's not getting enough blood.Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.

  • Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.
  • Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.
  • Stage four: The surfaces of the nearby wrist bones are damaged, resulting in arthritis of the wrist.
  • Stage one Kienbock's disease is usually treated using nonsurgical treatments. Doctors may suggest immobilizing the wrist in a cast for up to three months. It is possible that the blood supply to the lunate will return and the disease will clear up during this time. If the patient has what's known as

Stage one Kienbock's disease is usually treated using nonsurgical treatments. Doctors may suggest immobilizing the wrist in a cast for up to three months. It is possible that the blood supply to the lunate will return and the disease will clear up during this time. If the patient has what's known as

Stage one Kienbock's disease is usually treated using nonsurgical treatments. Doctors may suggest immobilizing the wrist in a cast for up to three months. It is possible that the blood supply to the lunate will return and the disease will clear up during this time. If the patient has what's known as

Stage one Kienbock's disease is usually treated using nonsurgical treatments. Doctors may suggest immobilizing the wrist in a cast for up to three months. It is possible that the blood supply to the lunate will return and the disease will clear up during this time. If the patient has what's known as

Stage one Kienbock's disease is usually treated using nonsurgical treatments. Doctors may suggest immobilizing the wrist in a cast for up to three months. It is possible that the blood supply to the lunate will return and the disease will clear up during this time. If the patient has what's known as

Operative treatment can be broken down into several major categories, including 1) revascularization 2) intercarpal fusion; 3) lunate excision; 4) lunate decompression and joint-leveling procedures; 5) proximal row carpectomy; and 6) wrist fusion.Operative treatment can be broken down into several major categories, including 1) revascularization 2) intercarpal fusion; 3) lunate excision; 4) lunate decompression and joint-leveling procedures; 5) proximal row carpectomy; and 6) wrist fusion.Operative treatment can be broken down into several major categories, including 1) revascularization 2) intercarpal fusion; 3) lunate excision; 4) lunate decompression and joint-leveling procedures; 5) proximal row carpectomy; and 6) wrist fusion.

Operative treatment can be broken down into several major categories, including 1) revascularization 2) intercarpal fusion; 3) lunate excision; 4) lunate decompression and joint-leveling procedures; 5) proximal row carpectomy; and 6) wrist fusion.

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A

wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A wrist joint. As described above, this can lead to increased pressure on the lunate and may be contributing to the problem. Your surgeon may recommend a joint leveling procedure to reduce the pressure on the lunate. Doing this may allow the bone to heal and revascularize, or it may at least slow the progression of the arthritis in the joint. A In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

In stage four (late-stage) Kienbock's disease, surgeons focus on treating the wrist osteoarthritis that results when the lunate collapses and dies. One surgical option at this stage is

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