Kienbock's Disease

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