Kienböck's disease
Review articleOpen access
Abstract:

AbstractKienböck's disease, also known as lunatomalacia, is a disorder of the carpal lunate characterized by bone density changes, progressive fragmentation, and collapse, ultimately resulting in global carpal destabilization and wrist joint osteoarthritis. The etiology of this disease remains controversial. Some authors consider it to be the consequence of repetitive trauma causing microfractures which do not heal due to a congenitally deficient vascularization in a mechanically adverse environment. However, other investigators do not believe these fractures to be the cause and regard Kienböck's disease as the consequence of bone necrosis due to an interruption of the intraosseous vascular supply. Early diagnosis and treatment is essential in order to halt its usually adverse progression and minimize problems. In the initial stages attempts at bone revascularization may be successful, while in more advanced conditions this is seldom successful. When the bone has fractured and collapsed, the goal of treatment is to prevent further carpal destabilization and global joint degeneration.

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