Lichtman DM, Alexander AH, Mack GR, Gunther SF. Kienbock’s disease: The role of silicone replacement arthroplasty. J Bone Joint Surg Am ; Antuña Zapico JM. Enfermedad de Kienbock. Rev. t ; 37 IB ( Supl.I): Antuña Zapico JM. Malacia del Semilunar. Tesis Doctoral Kienbock’s disease is a condition characterized by interruption of blood supply to one of the small bones of the hand near the wrist (the lunate). If blood supply to.

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Avascular necrosis of the lunate and sickle cell anaemia. A and B Global sclerosis of the lunate, kienbbock large volar perforations of the lunate and triquetrum. Conclusion In the above paragraphs we have separated the various aspects of KD, and how it affects the lunate and the wrist. However, all of these aspects are interrelated, and vary with time. He has failed conservative measures including prolonged immobilization. Kenzora J, Glimcher M.

There is also increased uptake on the radial aspect of the distal radius due to the abnormal loading. Crock studied the venous osseous drainage of the lunate, describing the extraosseous veins accompany the arteries. A negative ulnar variance is important, kiennock the ulnar is then unable to disperse the load from the lunate or triquetrum.

Kienbock’s Disease – Hand – Orthobullets

Stress Fracture of the Lunate Prior to the stress fracture occurring in the lunate, while the lunate is being abnormally loaded, a physiological response can be seen on imaging. J Plast D Hand Surg. Wilke B, Kakar S. Hand Surg ; 14 a, 2, part 1, A A composite image of subarticular venous plexus and 3D micro-CT of the subchondral bone plate.


The Etiology and Pathogenesis of Kienböck Disease

kkienbock With repetitive loading, a stress microfracture will occur, and with further loading, the fracture will propagate. Taniguchi Y, Tamaki T. This article has been corrected. L7 – years in practice. The uncovered type I lunate is positioned on the radial edge of the lunate, and with power grip in ulnar deviation loads on the radial edge of the radius.

Journal List J Wrist Surg v.

Beitrr z Klin Chir ; HPI – Patient is a 22 year old healthy LHD male college student with more than 6 months of pain and stiffness enfermedae his right wrist. Post-traumatic osteonecrosis of the lunate after fracture of the distal radius. Hand Surg ; 20 A, 1: He denies any recent history of trauma to the wrist or hand.

Proximal Row Instability Proximal row instability is due to disruption of the linkage between the three columns. Degeneration of the articular cartilage occurs concurrently and can accelerate this process.

The increased osseous compartment pressure further potentiates the venous obstruction, producing avascular necrosis. L8 – 10 years in practice. A single traumatic event such as a translunate fracture rarely leads to avascular necrosis.

If not loaded repetitively, the microfracture in the lunate can heal spontaneously.

Therefore, changes in the central column will have a secondary effect on the radial column. Clinical Orthopaedics ; Lunate collapse, fixed scaphoid rotation.

Excision of the lunate was performed with postoperative immobilization for one month. Note that most of dr cortex is still present but fragmented. Infectious Diseases in Clinical Practice ; Please vote below and help us build the most advanced adaptive learning platform in medicine.


Kienbock’s Disease

Bone edema and hyperemia can be identified on gadolinium-enhanced magnetic resonance imaging MRI and osteoblastic activity can be seen on a single-photon emission computed tomography SPECT scan Fig. L6 – years in practice. The articular manifestations of systemic lupus erythematous SLE: The articular surfaces are the interfaces that allow motion and transmit the load from their column. Secondary articular degenerative changes are common at the time of presentation, engermedad fortunately the radioscaphoid articulation is usually preserved.

Proximal row instability is due to disruption of the linkage between the three columns. We kienboc that the stress fracture violates the parallel veins of the venous subarticular plexus—leading to localized venous hypertension and subsequent ischemia and edema of the fatty marrow. Conflict of Interest None. Image courtesy of Crock AO. With ulnar deviation the capitate loads principally onto the lunate, which is then distributed to the proximal lunate, at the point where it enfernedad with the ulnar lip of the radius.

Tech Hand Up Extrem Surg. Hand Surg ; 7: Capitate shortening and capitohamate fusion. Experimental osteonecrosis of the lunate. Despite this, the patient continues to complain of weakness, stiffness, and pain with exertion of right hand.