Kienbock disease, more accurately spelled Kienböck disease, is a wrist disorder. In patients with this disease, one of the small bones in the middle of the wrist dies as a result of an interruption to its blood supply, leading to pain and decreased wrist mobility. Treatment options can include splinting and surgery to support the wrist. Generally, only one wrist is involved.
The origins of Kienbock disease are not well understood. Some researchers believe it may start with wrist trauma or damage to the blood vessels caused by high blood pressure. Patients usually think they have sprained wrists at first, as the wrist will be stiff, sore, and tender. The patient's wrist may feel hot as a result of inflammation, and it is usually difficult to rotate the wrist, particularly to turn the hand upwards.
This condition happens when the blood supply to the lunate bone is cut off. This eventually causes tissue death, as the bone does not receive the nutrients it needs. The bone begins to break down and collapse, causing a weak spot to develop in the wrist, and the lunate bone in the middle of the wrist will appear bright as a result of the inflammation and damage to the bone. When a patient reports to a doctor with wrist pain, an X-ray is usually ordered to learn more about what is happening inside the body.
A conservative option for treating Kienbock disease is simply to splint the wrist to provide support. The patient may also take medications to treat inflammation and pain. Surgical options are also available to treat the condition. Seeing a hand surgeon can be the best option, as these specialists focus on caring for the hands and wrists. They are familiar with the latest treatment options, and also have extensive experience in surgery.
Sometimes, the pain in the wrist is not immediately connected to Kienbock disease. Before ordering X-rays and other tests, a doctor may advise her patient to rest a sore wrist and take anti-inflammatory drugs to see if the condition resolves that way. People who do not respond to initial treatment for a strained or sprained wrist should request more evaluation to see if there is an underlying issue like Kienbock disease, a break, or another problem. The patient can request a referral to a specialist if there are concerns about the adequacy of treatment.