Kienböck's disease is a chondropathy of the lunate bone that can lead to its fragmentation and complete destruction. The main symptom of Kienböck's disease is wrist pain that worsens with movement. Then swelling occurs at the base of the hand, and gradually, mobility in the wrist joint becomes limited, which in turn leads to decreased muscle function in the forearm and their atrophy.
At the Hand Surgery Center of the Ichilov (Sourasky) clinic, successful surgeries for the restoration and removal of the lunate bone are performed. The surgeons at the Center possess the highest qualifications and extensive clinical experience, and they expertly handle the most modern medical equipment and innovative techniques.
Kienböck's Disease: Advantages of Treatment at the Ichilov (Sourasky) Clinic
One of the main causes of Kienböck's disease is a single or repetitive injury that leads to impaired blood supply to the wrist bones. Kienböck's disease is more common in individuals who work with significant physical strain on their hands.
At the Hand Surgery Center of the Ichilov (Sourasky) clinic, orthopedic surgery specialists accurately and quickly diagnose Kienböck's disease, subsequently performing surgeries that fully restore hand mobility.
The diagnosis of Kienböck's disease primarily involves X-ray imaging of the wrist. Then, depending on the progression of the disease, the following procedures are performed:
- In the initial stage of Kienböck's disease, a plaster cast is applied for 2-3 months to limit hand mobility. After this period, the patient undergoes courses of massage, physiotherapy, and therapeutic exercise. If all these procedures do not lead to an improvement in condition, surgical treatment is applied.
- In the early stages of the disease, revascularization is performed to restore blood supply by transplanting a piece from the distal radius with its blood vessels into the lunate bone. Bone grafting from the iliac crest or from the metacarpal bone is also possible. All these are technically complex surgeries performed using microsurgical methods. After surgery, to ensure the transplanted bone integrates and blood supply is restored, the hand is immobilized with a splint or orthosis for 3-4 weeks. After that, to assess the healing process, control X-rays are taken every 4 weeks. Typically, restoration of blood flow throughout the lunate bone takes 16-24 weeks.
- In more severe stages of Kienböck's disease, when complete destruction of the lunate bone occurs and restoration is impossible, the bone is completely removed (excision of the lunate bone). Previously, after the removal of the lunate bone, a void remained, disrupting the overall balance of the wrist bones. Today, techniques are used to replace the lunate bone with a tendon segment sutured to adjacent bones or with a lunate bone prosthesis.