Kienböck's disease--late results by non-surgical treatment. A follow-up study

Two groups of patients with Kienböck's disease were followed. Twenty-three wrists had been immobilised with plaster and twenty-six had no treatment. At follow up there was a marked improvement in both groups. Eighty-three percent of the wrists in the new treated group were pain free, or reported pain only on heavy work, and in the nontreated group this was valid for 77%. Examining X-rays at follow up we did not find a single wrist in which the lunate was normal or less deformed than at the time of diagnosis. In all forty-nine wrists the lunate was deformed and in 67% osteoarthrosis in the radiocarpal joint was evident. It is concluded, that Kienböck's disease has a naturally benign course, the remaining symptoms at follow-up might be caused by osteoarthrosis and nothing seems to be gained by rigorous immobilisation. If pain persists efficient treatment must be based on surgical methods.