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Kienbock's disease.
F Schuind1, S Eslami, P Ledoux
1Department of Orthopaedic Surgery, Erasme University Hospital, Université libre de Bruxelles, Route de Lennik 808, B-1070 Brussels, Belgium. frederic.schuind@erasme.ulb.ac.be
The Journal of Bone and Joint Surgery. British Volume
|February 8, 2008
Summary
Kienböck's disease, a wrist condition affecting the lunate bone, has an unknown cause but may involve anatomical variations and trauma. Treatment options vary, with radial shortening showing promise for specific patient groups.
Area of Science:
- Orthopedics
- Radiology
- Pathology
Background:
- Kienböck's disease is osteonecrosis of the lunate bone.
- Its etiology is unknown, but potential predisposing factors include morphological variations and trauma.
- Diagnosis relies on radiography, with MRI and CT scans offering supplementary information.
Purpose of the Study:
- To review the current understanding of Kienböck's disease.
- To discuss diagnostic methods and classification systems.
- To explore treatment options and their efficacy.
Main Methods:
- Literature review of Kienböck's disease.
- Analysis of diagnostic imaging techniques (radiography, MRI, CT).
- Review of treatment strategies, including immobilization and surgical interventions.
Main Results:
- Morphological variations and vascular patterns are potential predisposing factors.
- Lichtman classification system categorizes the disease into five stages.
- Symptoms do not consistently correlate with radiographic changes or carpal collapse.
Conclusions:
- The natural history and optimal treatment for Kienböck's disease remain unclear.
- Temporary wrist immobilization may offer symptomatic relief but doesn't halt progression.
- Radial shortening is a potential treatment for specific stages and patient profiles.
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