Surgical Options for Treatment of Kienbocks Disease

If the non-surgical treatment options for Kienböck's Diease do not reduce pain, swelling, and increase range of motion, the patient is often referred to an orthopedic surgeon to undergo counseling to see if surgical treatment can help. There are several surgical options for the more advanced stages of Kienböck's. Of course the course of treatment taken is up to the discretion of the doctor and his or her patient and depends on many factors including the severity of the disease, activity level, personal goals, and the surgeon’s prior experience.
 
In some cases, a surgeon may wish to try for revascularization, or a procedure, which returns the blood supply to the bone using a bone graft from the inner bone of the lower arm. This bone is secured to the wrist with an external fixator and used to relieve pressure on the lunate with the hope of preserving the existing space between the bones.
 
Another procedure the surgeon may opt for is called a joint leveling procedure. This treatment course is often used if the bones of the lower arm are uneven in length. The bones can be made longer using bone grafts or can be made shorter by removing a portion of the bone. This leveling procedure reduces the forces that compress the lunate and may halt the progression of the disease.
 
If the lunate is already collapsed and the disease has already progressed to stage 3 or stage 4, these bone fragments can be removed by your surgeon. This procedure is called a proximal row carpectomy and will relieve pain while maintaining partial wrist range of motion.
 
Finally, another procedure that may aid with the reduction of pressure on the wrist and subsequently with the pain and loss of motion associated with Kienböck's Disease is bone fusion. This is a fairly common procedure with patients who have compressed lower lumbar discs. By fusing several of the small bones in the wrist together, a doctor can reduce the pain and help maintain function. A patient should understand that fusion will limit the overall range of motion in the wrist.
 
If you think you have Kienböck's Disease in its more advances stages, you should see a doctor immediately and discuss the treatment options with him or her. If you are looking for further information about Kienböck's Disease and the treatment options, see here.