Kienböck’s disease (Kienböck, 1910) affects the lunate bone in patients who are usually in their twenties, and present with pain, swelling and stiffness of the wrist. Almost every treatment currently suggested for Kienböck’s disease is based on an hypothesis rather than proven knowledge. We treat it in the hope that what we are doing is logical and likely to benefit our patients. There are many questions that we should be prepared to answer and we list some we must address. A century after Kienböck’s description of this disorder a number cannot yet be answered adequately. This paper explores areas of uncertainty.
Antuña ZapicoJM. Malacia del semilunar. Vallodolid: University of Vallodolid, 1966.
2.
BeckenbaughRDShivesTCDobynsJHLinscheidRL. Kienböck’s disease: the natural history of Kienböck’s disease and consideration of lunate fractures. Clin Orthop Relat Res. 1980, 98–106.
3.
BochudRCBuchlerU. Kienböck’s disease, early stage 3 – height reconstruction and core revascularization of the lunate. J Hand Surg Br. 1994, 19: 466–78.
4.
DelaereODuryMMolderezAFoucherG. Conservative versus operative treatment for Kienböck’s disease. A retrospective study. J Hand Surg Br. 1998, 23: 33–6.
5.
DornanA. The result of treatment of Kienböck’s disease. J Bone Joint Surg Br. 1949, 31: 518–20.
6.
EvansGBurkeFDBartonNJ. A comparison of conservative treatment and silicone replacement arthroplasty in Kienböck’s disease. J Hand Surg Br. 1986, 11: 98–102.
7.
GelbermanRHBaumanTDMenonJAkesonWH. The vascularity of the lunate bone and Kienböck’s disease. J Hand Surg Am. 1980, 5: 272–8.
8.
GelbermanRHSalamonPBJuristJMPoschJL. Ulnar variance in Kienböck’s disease. J Bone Joint Surg Am. 1975, 57: 674–6.
9.
GlimcherMJKenzoraJE. Nicolas Andry award. The biology of osteonecrosis of the human femoral head and its clinical implications: 1. Tissue biology. Clin Orthop Relat Res. 1979, 284–309.
10.
HulténO. Über anatomische Variationen der Hand-Gelenkknochen. Acta Radiol. 1928, 9: 155–69.
11.
KeithPPNuttallDTrailI. Long-term outcome of nonsurgically managed Kienböck’s disease. J Hand Surg Am. 2004, 29: 63–7.
12.
KienböckR. Über traumatische Malazie des Mondbeins und ihre Folgezustände: Entartungsformen und Kompressionsfrakturen. Fortschritte auf dem Gebiete der Roentgenstrahlen. 1910, 16: 77–103.
13.
KristensenSSThomassenEChristensenF. Kienböck’s disease – late results by non-surgical treatment. A follow-up study. J Hand Surg Br. 1986, 11: 422–5.
14.
LichtmanDMMackGRMacDonaldRIGuntherSFWilsonJN. Kienböck’s disease: the role of silicone replacement arthroplasty. J Bone Joint Surg Am. 1977, 59: 899–908.
15.
MacDermidJCTurgeonTRichardsRSBeadleMRothJH. Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma. 1998, 12: 577–86.
16.
MennenUSithebeH. The incidence of asymptomatic Kienböck’s disease. J Hand Surg Eur. 2009, 34: 348–50.
17.
SalmonJStanleyJKTrailIA. Kienböck’s disease: conservative management versus radial shortening. J Bone Joint Surg Br. 2000, 82: 820–3.
18.
StåhlF. On lunatomalacia – Kienböck’s disease. A clinical and roentgenological study, especially on its pathogenesis and the late results of immobilisation treatment. Acta Chir Scand. 1947, 95(Suppl): 126–126.
19.
TaniguchiYTamakiTHondaTYoshidaM. Rotatory subluxation of the scaphoid in Kienböck’s disease is not a cause of scapholunate advanced collapse (SLAC) in the wrist. J Bone Joint Surg Br. 2002, 84: 684–7.
