What is it?
Avascular necrosis of the bone with one of a number of proximal carpal bone-lunate bone. Her appearance and development of life can cause discomfort (minor aches) or lead to degradation of the wrist (stiffness) due to the destruction of the lunate bone and the destabilization of the whole of the bones of the wrist to the creation of extensive degenerative changes.

Cause

It is associated with impaired blood supply to the bone, but you can not clearly determine what triggers the disease onset. It takes into account injuries (eg. Repeated microtrauma), disorder of supply (arteries) and outflow (vein) of blood from the bone. You can also exclude the impact of other diseases on the development of the Kienbock's disease.

Symptoms

The most common symptom is pain located above the wrist bone. Pain aggravated when using the hand.

Testing and diagnosis

The survey is based on accurate intelligence gathering and examination of the hand. Performs a hand X-ray of the wrist, but in the early stages of the disease changes may not be visible. The decisive test is the execution IMR Magnetic Resonance or Computed Tomography.

Treatment

In the early stages of the disease can be used to immobilize the wrist brace / cast. In the event of changes in the more advanced it is necessary to perform surgery (revascularization of bone, remove bones, bone implants, shortening the bones of the forearm, wrist brace). The choice of the type of operation depends on the degree of advancement of the disease. A method of treatment should be carefully discussed with the patient before it starts.

After the surgery

The course and the time of disease progression is unpredictable. Applied conservative treatment may not produce the desired effects. After the surgery may be necessary to use immobilization (plaster / orthosis) for several weeks. Hand hold a sling, if it is prescribed rehabilitation should I start.