Kienbock’s Disease is a relatively rare condition, named after Dr. Robert Kienbock, the radiologist in Vienna who described the condition in 1910 noted that the disease is a fragmentation of the lunate bone in the wrist joint due to impaired blood circulation to the bone, leading to bone friction, deformation, and joint pain. The exact and definitive cause of Kienbock Disease is still unknown, but it is believed that there are some factors that predispose a person to it. It can occur in cases of wrist trauma, such as a complex fracture, and may happen in workers who perform heavy manual labor. In these cases, it may cause some arteries responsible for supplying blood to the lunate bone to be cut off. Some studies indicate that most people who suffer from Kienbock’s disease are affected in their dominant hands and their ages range between 20 and 45 years, and in very rare cases, people get the disease in both wrists.
Diagnosis:
• Symptoms usually begin with gradual pain in the lunate bone area located in the middle of the wrist at the base; afterwards, swelling may occur over the wrist joint which may become stiff. This disorder occurs in both hands in 10% of people.
• Kienbock’s disease can be diagnosed early through MRI or CT scans. Changes in X-rays only appear in advanced stages as lunate bone fragmentation and wrist bone deformation.
Treatment:
• Mild deformity usually only requires the use of plastic splints during manual labor.
• However, in the case of severe deformity or deformity in a person needing manual effort, surgery is required.
• Surgeries generally focus on redistributing the pressure within the joint by altering the length of the radius or ulna bone.
• In cases of severe osteoarthritis, the surgery involves removing the proximal row of wrist bones or the deteriorated bone and replacing it with soft tissues from the patient.
• Joint fusion surgery can also be performed in late-stage cases.
Wishing you all good health and well-being.
Dr. Mahdi Abd Al-Sahib
Orthopedic surgeon
