KIENBÖCK’S DISEASE

V. Sollazzo

Medical Center, Ferrara, Italy

Correspondence to:
Vincenzo Sollazzo, MD

Orthopedic Surgeon, Medical Director, Medical Center, Ferrara, Italy
e-mail: slv@unife.it

ABSTRACT

 Persistent avascular osteonecrosis of lunate bone is the medical term for the uncommon condition known as Kienböck’s disease (KD). The typical indications of this condition include a restriction in motion on one side of the wrist and pain and oedema in that area. Although there have been some recent developments in therapeutic approaches, the etiology and pathophysiology of the condition are still not well understood. In addition to direct trauma, frequent risk factors include anatomical traits such as ulnar variation, changes in blood flow, and more significant intraosseous pressure. Radiographic features evaluated using a modified version of the Lichtman scale are the primary factor in determining the KD stage. The selection of treatment choices is frequently challenging because radiographic findings do not always precisely match the first clinical symptoms and can vary depending on the patient’s age group. When KD is detected in its initial stages, nonoperative therapy consisting of unloading is typically recommended. Vascularized bone grafting is one of the most recent surgical methods implemented in Stage III cases. A vascularized, pedicled scaphoid graft combined with partial radioscaphoid arthrodesis is one of the techniques that have been reported. This approach provides good pain control and prevents carpal collapse.

Keywords: Kienböck’s disease, lunatomalacia, lunate, carpal bone, ulnar bone