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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The stress fracture occurs, at the point where the fulcrum loads the cantilever. A negative ulnar variance is important, as the ulnar is dde unable to disperse the load from the lunate or triquetrum. DOI of the erratum is Diagrammatic representation of the normal vascularization of the lunate superior half with the enfermeadd fat cell and venous drainage. The articular manifestations of systemic lupus erythematous SLE: Conclusion In the above paragraphs we have separated the various aspects of KD, and how it affects the lunate and the wrist.

Received Mar 23; Accepted Apr 6. Universidad de Valladolid, Servicio de Publicaciones; Tech Hand Up Extrem Surg. HPI – Patient is a 22 year old healthy LHD male college student with more than 6 months of pain and stiffness in his right wrist. A Fragmentation and collapse of the lunate. The venous obstruction produces edema of the fat cells, which potentiates the hypertension. We believe this is in part related to the venous hypertension.

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With repetitive loading, a stress microfracture will occur, and with further loading, the fracture will propagate. Hand Surg ; 20 A, 1: J Hand Surg Eur Vol. A single traumatic event such as a translunate fracture rarely leads to avascular necrosis. Therefore, changes in the central column will have a secondary effect on the radial column. This creates a static deformity, which in time becomes a fixed deformity.

Ulnar lengthening of 4mm. Degeneration of the Central Column Perilunate Articulations Fractures of the lunate subchondral bone plate produce irregularity of the lunate articular surface. Which of the following imaging studies would be most sensitive for determining the stage of this patient’s underlying condition? How would you treat this patient’s Kienbocks’s disease? Revascularization may cause collapse.

Oienbock also described the subarticular venous plexus, which are parallel veins positioned just below the subchondral bone plate Fig. Uber anatomische variationen der handgelenkknochen. National Center for Biotechnology InformationU. Please review kienbodk privacy policy. Advances in Diagnosis and Treatment. We postulate 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.

Association between lunate morphology and carpal collapse in cases of scapholunate dissociation. The four corner fusion is a good surgical option for late scapholunate advanced collapse SLAC wrist disease, as it bypasses the diseased radial column and mobilizes the wrist through the stabilized the central column. This leads to tamponade of the sinusoids, thus decreasing the venous outflow.

Proximal row instability is due to disruption of the linkage between the three columns. If the fracture remains localized, it can heal kienbkck settle into a stable configuration, so that the wrist remains functional.

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The Etiology and Pathogenesis of Kienböck Disease

Labowitz R, Schumacher H. The uncovered type I lunate. Despite this, the patient continues to complain of weakness, stiffness, and enfermwdad with exertion of right hand. Uber anatomische variationen der Handgelenknochen. With time this leads to degenerative arthritis of both the radiolunate and lunocapitate joints. A A composite image of subarticular venous plexus and 3D micro-CT of the subchondral bone plate.

Arthroscopic assessment and classification of Kienbock’s disease. Wilke B, Kakar S.

Kienbock’s Disease

Trumble T, Irving J. In the active male, repetitive loading causes the stress fracture that commences in the single layer proximal subchondral bone plate. The scaphoid is forced into flexion by the trapezium, however, degeneration of the scaphoid and scaphoid facet only occurs in late disease or following failed surgery.

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Lichtman’s name in the article has been corrected as per erratum published on May 18, In addition, a significant asymptomatic older population has been identified. 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.

Hand Surg ; 24 B, 5: