- Bilateral Kienbock's disease
- Kienbock disease
Your QuestionIs there a cure for Kienbock's disease that doesn't involve surgery?
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In some cases, it is possible to return the blood supply to the bone, a process called revascularization. This procedure involves taking a portion of bone (a graft) from the inner bone of the lower arm. In some cases, a metal device called an external fixator may be used to relieve the pressure on the lunate and preserve the spacing between bones.
If the bones of the lower arm are uneven in length, a joint leveling procedure may be recommended. Bones can be made longer using bone grafts or shortened by removing a section of the bone. This leveling procedure reduces the forces that bear down on or compress the lunate and may halt progression of the disease.
If the lunate is severely collapsed or fragmented into pieces, it can be removed. In this procedure, the two bones on either side of the lunate are also removed. This procedure, called a proximal row carpectomy, often relieves pain while maintaining partial wrist motion.
Another procedure that can ease the pressure on the bone is fusion. In this procedure, several of the small bones of the hand are fused together. If the disease has progressed to severe arthritis of the wrist, fusing the bones may reduce pain and help maintain function. A drawback to this type of procedure is that the range of wrist motion may become limited.
To learn more about the surgical options available for the management of Kienbock's disease, click here.
- Divelbiss BJ, Baratz ME. Kienbock Disease. eMedicine. 2010; http://emedicine.medscape.com/article/1241882-overview. Accessed 8/16/2011.
- Kienbock's Disease. American Academy of Orthopaedic Surgeons. October 2007; http://orthoinfo.aaos.org/topic.cfm?topic=a00017. Accessed 8/16/2011.