Kienböck Disease

Kienböck Disease

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Kienböck Disease is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Lunatomalacia
  • Osteochondrosis of the Lunate Bone

Disorder Subdivisions

  • None

General Discussion

Kienböck Disease is an acquired bone disorder. Abnormalities of the lunate bone in the wrist develops following an injury or inflammation. Recurrent pain and stiffness occur in conjunction with thickening, swelling and tenderness in soft tissue overlying the lunate bone. The range of motion in the wrist may become limited.

Symptoms

Kienböck Disease is characterized by degenerative changes in the lunate bone of the wrist. Softening, deterioration, fragmentation or compression of the affected bone can occur. These changes may produce pain, swelling, tenderness, thickening and/or stiffness in the overlying tissues of the wrist. The range of motion may become restricted. Many individuals with Kienböck Disease have a shorter ulna than radius (negative ulnar variance). Healing occurs through formation of new bone in some cases.

Causes

The exact cause of Kienböck Disease is not known. However, it is believed to be caused by inflammation or injury of the wrist.

Affected Populations

Kienböck Disease usually begins during childhood and seems to affect females more often than males.

Standard Therapies

Diagnosis

Arthroscopic procedures, CT scan and/or x-ray imaging may be used for diagnosis.



Treatment

The treatment of Kienböck's Disease may involve surgery of the lunate bone, shortening of the radial bone, lengthening of the ulna or the stiffening of the joints through an operation (arthrodesis). Cutting off the nerve supply of the wrist (wrist denervation) has been used in conjunction with some of the other procedures. Surgical options depend on how far the disease has progressed and the best option will differ for each individual.



If inflammation of the wrist has occurred, drug treatment may be recommended. Other treatment is symptomatic and supportive.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com

References

TEXTBOOKS

Current Diagnosis & Treatment in Orthopedics, 1st Ed.: Harry B. Skinner, Editor; Appleton & Lange, 1995. P. 494.



JOURNAL ARTICLES

Excision of the Lunate in Kienböck's Disease. Results After Long-Term Followup. H. Kawai et al.; J Bone Joint Surg [Br] (Mar 1988; 70(2)). Pp. 287-92.



Ulna-Minus Variance and Kienböck's Disease. P. A. Nathan et al.; J Hand Surg (Sept 1987; 12(5 pt 1)). Pp. 777-78.



Wrist Denervation Procedures in the Treatment of Kienböck's Disease. D. Buck-Gramcko; Hand Clin (Aug 1993; 9(3)). Pp. 517-20.



Review of Treatment Results in Kienböck's Disease. S. H. Kuschner et al.; Orthop Rev (Jun 1992; 21(6)). Pp. 717-28.



Osteomalacia of the Lunate Bone-Indications for and Limitations of Radial Shortening and Ulnar Lengthening. M. Fishcer et al.; Orthopade (Feb 1993; 22(1)). Pp. 52-56.



Long-Term Results of 9 Cases of Elongation of the Ulna in Treatment of Kienböck's Disease. P. Ducarmois et al.; Ann Chir Main Memb Supter (1997; 16(1)). Pp. 16-24.



Kienböck's Disease: Treatment by Implantation of Vascular Pedicle and Bone Grafting. M. S. Moneim et al.; Iowa Orthop J (1998; 18). Pp. 67-73.



Kienböck Disease and Negative Ulnar Variance. M. Bonzar et al.; J Bone Joint Surg Am (Aug 1998; 80(8)). Pp. 1154-57.



Arthroscopic Evaluation of Radial Osteotomy for Kienböck's Disease. K. Watanabe et al.; J Hand Surg (Sept 1998; 23(5)). Pp. 899-903.



Proximal Row Carpectomy Versus Limited Wrist Arthrodesis for Advanced Kienböck's Disease. R. Nakamura et al.; J Hand Surg (Dec 1998; 23(6)). Pp. 741-45.



FROM THE INTERNET

eMedicine - Kienböck Disease : Article by Brian J Divelbiss, MD

Resources

NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

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For a Complete Report

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