Kienböck’s Disease | Orthopaedics | Loyola Medicine

Kienböck’s Disease

Overview and Facts about Kienböck’s Disease

Kienböck’s disease is a chronic condition that limits blood supply to the lunate bone, which is a small bone located in the middle of the base of your wrist. The lunate bone is one of the many bones involved in wrist movement. Loss of blood to the lunate bone can lead to pain and loss of movement in the wrist. Usually, Kienböck’s disease only affects one wrist.

Signs and Symptoms of Kienböck’s Disease

The first and most obvious symptom experienced with Kienböck’s disease is pain. It may not be too noticeable at first, but it will worsen as the disease progresses. Other symptoms that may appear over time include:

  • Swelling
  • Stiffness
  • Tenderness above the bone
  • Problems turning your palm upward
  • Loss of grip strength
  • Clicking when rotating your wrist

Symptoms of Kienböck’s disease will intensify through the four different stages of the disease, which are:

  • Stage 1, where there is decreased blood flow, but its affects are not yet visible on an X-ray.
  • Stage 2, where the lunate begins hardening, with signs now visible on an X-ray.
  • Stage 3, where the lunate begins to die and break apart, pushing the other wrist bones out of place.
  • Stage 4, where the bones surrounding the lunate also begin to break apart.

Causes and Risk Factors of Kienböck’s Disease

The cause of Kienböck’s disease has not yet been determined. Like other orthopedic conditions, Kienböck’s disease is often related to an injury or trauma to the affected area, such as a fall or repetitive strain.

There are a few risk factors that can contribute to the development of Kienböck’s disease. These include:

  • A disparity in the shape or length of your forearm bones, which puts more pressure on the lunate.
  • Having certain diseases that affect blood supply, such as cerebral palsy, sickle cell anemia or lupus.
  • Having only one blood vessel that supplies blood to the lunate (most people have two).

Overall, Kienböck’s disease is most common between men of 20 to 40 years of age.

Tests and Diagnosis of Kienböck’s Disease

If your Kienböck’s disease is still stage 1, it can be very tricky to diagnose because it might just resemble a wrist sprain. To determine the cause of your symptoms, your doctor will perform a physical exam and order an X-ray to get a closer look at your wrist bones.

Treatment and Care for Kienböck’s Disease

Once you’ve been diagnosed with Kienböck’s disease, your treatment will depend on the stage of the disease.

For early stages, anti-inflammatory drugs, immobilization of the wrist and physical therapy are often enough to promote blood flow again. For more advanced stages, you might need one of the following procedures:

  • Revascularization, which involves using blood vessels and bone from another part of your body to help restore blood flow to your wrist.
  • Capitate-shortening osteotomy, which is when your doctor fuses parts of your wrist bone together.
  • Joint leveling, which is when your doctor shortens or lengthens your forearm bone to relieve pressure on the wrist.