Kienbock's Disease
Reviewed by Dr. Vipul Patel
Kienbock's Disease Treatment in Manhattan, Brooklyn, Queens and Englewood, NJ
Kienbock's disease is an uncommon condition that can cause gradually worsening pain and stiffness in the center of the wrist. Because early symptoms can resemble a sprain, it is sometimes diagnosed later than it could be.
We evaluate and treat Kienbock's disease at our offices on the Upper West Side of Manhattan, in Park Slope, Brooklyn, in Elmhurst, Queens, and in Englewood, NJ, with a plan matched to the stage of the condition.
What Is Kienbock's Disease?
Kienbock's disease occurs when the lunate, a small bone in the center of the wrist, loses part of its blood supply. Without enough blood flow, the bone can weaken, fragment and eventually collapse, which may lead to wrist arthritis. The exact cause is not fully understood. Factors that may play a role include the bone's blood supply pattern, repeated stress and a shorter ulna relative to the radius.
Stages of Kienbock's Disease
Kienbock's disease is commonly described in stages, from changes seen only on MRI, to increased density of the lunate on X-ray, to collapse of the bone, and finally to arthritis of the surrounding wrist joints. The stage helps guide treatment.
Symptoms
- Pain and tenderness in the middle of the back of the wrist
- Swelling
- Stiffness and reduced wrist motion
- Weak grip
How Kienbock's Disease Is Diagnosed
Your surgeon will examine your wrist and review X-rays. An MRI can detect early changes in the lunate before they appear on X-ray, and a CT scan may help assess fragmentation or collapse.
Nonsurgical Options to Try First
In early stages, treatment may include immobilization in a splint or cast, anti-inflammatory medication and activity changes. Some patients are monitored closely to see how the bone responds.
When Surgery May Be Recommended
Surgery may be considered when pain continues, when imaging shows progression, or when the lunate has started to collapse.
Surgical Options That May Be Considered
- Joint leveling procedures: such as radial shortening, which may reduce pressure on the lunate
- Revascularization: bringing a new blood supply to the bone with a vascularized bone graft
- Proximal row carpectomy: removing the first row of wrist bones in selected advanced cases
- Partial or total wrist fusion: for advanced arthritis, to relieve pain
Recovery
Recovery depends on the procedure and usually includes a period of protection in a cast or splint, followed by hand therapy. Bone procedures need time to heal, and your surgeon will monitor healing with follow-up imaging.
Why Choose Dr. Patel for Kienbock's Disease?
Dr. Vipul Patel, MD, FAAOS, is fellowship-trained in hand, upper extremity and microvascular surgery, with additional microsurgery experience at Columbia University. This background is relevant to procedures that address bone blood supply in the wrist.
Kienbock's Disease FAQs
Is Kienbock's disease caused by an injury?
Sometimes symptoms begin after an injury, but the condition is thought to involve several factors, including blood supply and wrist anatomy. A single cause is often not identified.
Can Kienbock's disease be cured?
Treatment aims to relieve pain and preserve wrist function. Results vary by stage, and earlier diagnosis may allow more treatment options.
Will I lose wrist motion?
Some procedures preserve more motion than others. Your surgeon can explain the expected trade-offs between pain relief and motion for each option.
Request an Appointment
If you have ongoing central wrist pain, request an appointment at our Manhattan, Brooklyn, Queens or Englewood, NJ office to discuss your Kienbock's disease treatment options.
