What is Kienbock's Disease?

By Alexander Holcomb

What is Kienbock’s Disease?

Kienbock’s Disease is a condition where blood flow is cut off to one of the small wrist bones named the lunate. Due to this lack of blood supply, the lunate bone becomes susceptible to breaks. The reason that this happens is unclear at the moment. The current belief is that this disease has multiple, compounding causes, including injury to the wrist, irregular forearm bone length, and/or blood disorders.

What does Kienbock’s Disease look like?

There are multiple stages of this condition and each stage presents with different symptoms.

Stage 1: commonly feels like a wrist sprain. Individuals in this stage may experience wrist pain, swelling, bruising, and tenderness at the injury site. They may or may not have a normal x-ray.

Stage 2: this is the stage where the lunate bone starts to harden due to a lack of blood supply. This stage will have the same symptoms as stage 1 (wrist pain, swelling, tenderness), but will have visible changes on an x-ray.

Stage 3: this stage is associated with a fractured lunate bone. Individuals will have an increase in pain, decreased grip strength, and decreased wrist motion. When they get imaging, they will see that the lunate is in pieces.

Stage 4: this stage has similar symptoms as stage 3 (increased wrist pain, decreased strength and motion), however, this stage is associated with increased stiffness of the wrist that is worse in the morning.

How is Kienbock’s Disease treated?

To put it shortly, it depends. Factors such as a person’s bone structure, stage of the disease, and personal preference all play a role in how Kienbock’s disease is treated. Here are some common methods of treatment.

Non-surgical management: usually completed in physical therapy or occupational therapy. The focus of this treatment method is to improve the person’s ability to use their wrist through reducing the pain and swelling in the wrist, as well as immobilizing the wrist (if there is a break in the wrist).

Surgical management: there are a variety of surgical procedures that focus on restoring the blood flow to the lunate bone. Some of the procedures include placing a piece of a different wrist bone with a complete blood vessel into the lunate, changing the length of the forearm bones to put less pressure on the lunate bone, or removing the lunate along with the two wrist bones next to it.

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