Kienbock's disease

The lunatomalacia, also known as lunate osteonecrosis, Mondbeintod or Crohn Kienböck, is a disease in which there is a partial or complete death (medical: necrosis ) of the lunate bone ( lunate, carpal bones ) is coming.

The lunatomalacia is not a disease of the modern age, the disease has long been known, but could be assigned to the lunate only with the discovery of X-rays. The first description was in 1910 by the Austrian radiologist Robert Kienböck ( 1871-1953 ). In the Anglo - American world the names Kienbock 's disease, Lunatomalacia and aseptic necrosis are common. The disease is one of the aseptic bone necrosis.

Etiology

On the Origin of lunatomalacia there are no reliable data. Various underlying mechanisms are discussed:

• Stress fracture with subsequent devascularization when the os is lunate mainly supplied by a single, of volar / palmar artery coming.
• Recurrent micro-trauma to the wrist, such as manual activity with a hammer or a compressed air apparatus or sports

Symptoms

The disease is associated with severe pain in the wrist extensor side and indeed the level of the proximal carpal row and proceeds without treatment over several stages, until it finally comes to a complete resolution of the lunate. Parallel to this, there is a power loss in the affected hand and to significant restrictions in the mobility of the wrist.

Division into stages

The lunatomalacia is divided mainly to Decoulx / light man as follows:

In addition, a radiological classification according Stäbler and Vahlensieck is commonly used:

Diagnosis

In the early stages, the disease is not visible in conventional radiographs. It is therefore often not detected until very late. For diagnosis MRI and CT are.

Therapy

The treatment depends on the stage of the disease. Almost always require surgery.