Sixteen scaphotrapeziotrapezoid arthrodeses were performed for kienbocks disease. In kienbocks disease, the blood supply to the lunate, one of the small bones of the hand near the wrist is interrupted and the bone undergoes changes and eventually collapses. The purpose of this article is to provide an overview of kienbock disease focusing on imaging findings, including the relevant anatomy, pathophysiology, and treatment of kienbock disease and the differential diagnoses pseudokienbock lesions. Advanced imaging of kienbocks disease springerlink. Kienbocks disease and cerebral palsy case report sciencedirect. There were two males and two females with a mean age of 37 years at the time of surgery and 62 years at final followup. We suggest this simple technique in patients with neglected or failed previous treated kienbock disease with degenerative changes in lunate fossa. Download fulltext pdf kienbock disease article pdf available in online journal of health and allied sciences 84 april 2010 with 426 reads.
Kienbocks disease is a form of osteonecrosis affecting the lunate. Journal of the american academy of orthopaedic surgeons. Article information, pdf download for the classification and treatment of. Kienbock disease is a rare bone disorder of unknown etiology characterized clinically by osteonecrosis of the carpal lunate, eventually leading to. Aug 28, 2007 treatment of litchman stage 3 kienbocks disease is still controversial. Morphological variations, such as negative ulnar variance. Kienbock disease definition of kienbock disease by medical. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve.
Kienbock disease is it a disability doctor answers. Kienbocks disease is a rare disorder involving the lunate, one of the carpal bones, and is, therefore, not commonly included in the differential diagnosis of patients presenting to the emergency. This first edition textbook of kienbocks disease, published by springer publications, collects and synthesizes. Autopsies, particularly in cases which have received. Kienbocks disease is a relatively rare disorder that disrupts the blood supply to the lunate. Lichtman and gregory ian bain advances in diagnosis and treatment published by springer about the book. Yes, it is inherited on the x chromosome, which means that it is usually but not always worse in males. Cette pathologie du poignet fut decrite par kienbock en 1910.
Pdf treatment of advanced kienbocks disease lichtmann iv is commonly proximal row carpectomy or partial arthrodesis. Wrist fusion versus limited carpal fusion in advanced. A historical report on robert kienbock 18711953 and. The conventional method of ulnar lengthening with a plate and bone graft is fraught with complications including graft site morbidity, nonunion, hardware removal and difficulty in the achievement of a proper length. Robert kienbock, a radiologist in vienna, austria who described osteomalacia of the lunate in 1910. Six had total wrist fusions and 12 had limited carpal fusions. We used a umex distractor to achieve distraction osteogenesis in a group. Within the last few years there has been a considerable revival of interest in boecks sarcoid. In the past, kienbocks disease lunatomalacia, osteonecrosis, or aseptic necrosis of the lunate was diagnosed exclusively by plain radiography. Elle concerne souvent dun adulte jeune qui presente des douleurs.
Conservative treatment versus scaphotrapeziotrapezoid. Articles dealing with this disease have been appearing with increasing frequency. May 16, 2017 kienbocks disease is a relatively rare disorder that disrupts the blood supply to the lunate. Treatment of advanced kienbocks disease thieme connect.
In this study our aim was to evaluate the effectiveness of radial shortening on stage 3b kienbocks disease in comparison with stage 3a cases. Kienbock disease is a rare bone disorder of unknown etiology characterized clinically by osteonecrosis of the carpal lunate, eventually leading to collapse of the lunate bone impacting wrist function. The classification and treatment of kienbocks disease. Cpd questionnaires must be completed online via za after submission you can check the answers and print your certificate. Recent studies gay et al evaluated the use of a simple capitate osteotomy without arthrodesis, through a dorsal medial approach and fixed with staples, in 11 patients with mild forms stage i to iiia, lichtman classification of kienboc. New capabilities of computed tomography ct and magnetic resonance imaging mri have improved image quality due to both spatial resolution and contrast resolution with the use of gadolinium in mri. Conservative treatment versus scaphotrapeziotrapezoid arthrodesis for kienbock s disease.
Is radial shortening useful for litchman stage 3b kienbocks. The lunate is one of eight small carpal bones in your wrist. Kienbock disease is the eponymous name given to osteonecrosis involving the lunate. Many patients with kienbocks disease think they have a sprained wrist and in many cases there is a prolonged period of time until they are correctly diagnosed. Ulnar lengthening is an accepted modality of treatment to achieve joint levelling in kienbocks disease. Kienbock disease is avascular necrosis of the scaphoid bone. The proper treatment of kienbocks disease, a disorder that displays slow. Kienbocks disease, early stage 3height reconstruction and. Clinical presentation, natural history, and classification of. Scaphotrapeziotrapezoid arthrodesis in the treatment of. Distraction osteogenesis for ulnar lengthening in kienbocks. Kienbocks disease genetic and rare diseases information.
In ten cases, a prosthetic replacement of the lunate was inserted at the same time. Kienbock s disease is a condition characterized by interruption of blood supply to one of the small bones of the hand near the wrist the lunate. Advances in diagnosis and treatment is edited by david m. Kienbocks disease, also known as avascular necrosis of the lunate, was described in. Sep 27, 2019 kienbock disease is a condition of uncertain etiology that results in osteonecrosis of the carpal lunate. This document was downloaded for personal use only. By continuing to browse this site you are agreeing to our use of cookies. The proper treatment of kienbocks disease, a disorder that displays slow progression with eventual collapse of the lunate and alteration of the surrounding carpal architecture, requires an underst. Il sagit dune arthrodese scaphotrapezotrapezoidale associee a une resection du semilunaire. Although incompletely understood, the natural history of kienbocks disease is an essential consideration in the development of a comprehensive treatment plan.
A historical report on robert kienbock 18711953 and kienbocks disease article in the journal of hand surgery 306. Physicians should be aware that this disease is one of the causes of wrist pain. Definition avascular necrosis of the carpal lunate blood supply of the lunate receives supply from both dorsal and palmar surfaces in 80%, but volar surface only in 20% dorsal supply from dorsal radiocarpal arch dorsal intercarpal arch occasionally from d. Radial shortening was performed for 23 patients who had stage 3a group i, n and 3b group ii, n 10 kienbocks disease between 1994 and 2004. It is breakdown of the lunate bone, a carpal bone in the wrist that articulates with the radius in the forearm. We treated 18 patients with advanced kienbock s disease surgically. Hugon, pierrelouis docquier, maryline mousny and the belgian association of pediatric orthopaedics meeting. The visual analogue pain scores, the patient satisfaction scores and the sf 12 were better in the total wrist fusion group. Early stage 3 kienbocks disease has been treated by inner debridement, recontouring, height reconstruction, bone grafting and core revascularization of the lunate. Avascular necrosis of lunate first described by robert kienbock in 1910. We searched the ovidmedline and the cochrane library for articles discussing the etiology of osteonecrosis of the lunate published since. The age distribution for kienbock disease depends on gender.
Affected people may first think they have a sprained wrist and may have experienced trauma to the wrist, which can disrupt the blood flow to the lunate. Pdf kienbock s disease, or osteonecrosis of the lunate, can lead to chronic, debilitating wrist pain. Download kienbock disease download free online book chm pdf. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. It causes a variety of symptoms, which can be very severe.