musculoskeletal and connective tissue disorders
Kienböck Disease
Treatment of Kienböck Disease
Wrist splinting and analgesics for early stages Surgical procedures In early stages of Kienböck disease, wrist splinting may decrease pressure on the lunate, relieving pain and possibly helping to restore blood flow. Analgesics are given for pain. Surgical treatment of Kienböck disease is aimed at relieving pressure on the lunate by shortening the radius ( Treatment references ) or lengthening the ulna. Alternative treatments are done in an attempt to revascularize the lunate (eg, implanting a blood vessel or bone graft on a vascular pedicle; Salvage procedures (eg, proximal row carpectomy or intercarpal fusions) may help preserve some wrist function if the carpal joints have degenerated. Total wrist arthrodesis can be done as a last resort to relieve pain. Nonsurgical treatments are rarely effective. 1.Shin YH, Kim JK, Han M, et al: Comparison of long-term outcomes of radial osteotomy and nonoperative treatment for Kienböck disease: a systematic review.J Bone Joint Surg100(14):1231-1240, 2018. doi: 10.2106/JBJS.17.00764. 2.Afshar A, Eivaziatashbeik K: Long-term clinical and radiological outcomes of radial shortening osteotomy and vascularized bone graft in Kienböck disease.J Hand Surg Am38(2):289-296, 2013. doi: 10.1016/j.jhsa.2012.11.016. 3.Bürger HK, Windhofer C, Gaggl AJ, et al: Vascularized medial femoral trochlea osteochondral flap reconstruction of advanced Kienböck disease.J Hand Surg Am39(7):1313-1322, 2014. doi: 10.1016/j.jhsa.2014.03.040. 