Kienbock's disease

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Kienbock's disease occurs when the lunate bone develops patchy necrosis after acute or chronic injury.

The patient is usually a young adult who complains of an aching and stiff wrist. On examination, there is localised tenderness on the centre of the wrist dorsum. There may be a limitation of wrist extension.

Radiology will be normal at first. In later disease there will be increased bone density of the lunate. In late disease the bone will look squashed and irregular. This condition is often associated with a slightly short ulna (negative ulnar variance).

Treatment: in early disease an osteotomy of the radius may be performed so as to take pressure off the lunate and prevent bone collapse. In later disease other options such as a wrist arthrodesis may be considered.

Last reviewed 01/2018