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Kienbock's Disease

SUMMARY

Described by Kienbock in 1910, a radiologist in Vienna. (republished article in CORR 1980, Vol 149)

= collapse of the lunate due to vascular insufficiency and avascular necrosis


Aetiology:  

Uncertain

Theories:

  1. Single forgotten wrist trauma
  2. Repetitive microfractures that result in vascular comprimise, causing disruption of blood supply to lunate
  3. Recurrent compression of lunate between capitate & distal radius which disrupts the intraosseous structures through shear stress at extreme wrist positions and/or repetitive compression loading

Associated with Negative ulnar variance (of interest, there do not seem to be any reports of Kienbock's disease after the Darrach's procedure)


Clinical Manifestations: 

  • Young adults
  • wrist pain that radiates up the forearm 
  • wrist stiffness
  • tenderness over lunate dorsally
  • weakness of grip


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