What is Kienbock Disease?
Kienbock Disease (KD) is basically, where the blood supply to the Lunate bone in the wrist shuts off and the Lunate bone dies. There are different stages that depends on how much damage has been caused from the lack of blood supply. The bone dies and the body absorbs the dead tissue. This causes the other bones in the wrist to move out of place and rub against each other wrong. This creates a lot of pain.
Kienbock is considered "uncommon" instead of "rare". All that means is about one in every 150,000 - 200,000 or so get it.
There is no single known cause of Kienbock Disease. Some think over-use causes the problem, but there are many who get it that do not overuse the wrist. There is no one single cause of it. There does seem to be many factors that contribute to KD: Overuse, Injury, Genetics, Long Radius, Long Ulna, to just name a few. Most people with KD have varying combinations of factors. This also creates a problem when trying to find a treatment. The treatment depends on the person and the contributing factors.
Work habits may indeed be the cause for certain individuals. Most likely, it is just one of a few contributing factors.
The treatment for KD depends on what Stage you are in. In the early stages casting and immobilizing the wrist can help. About 50% of people with KD have long Radial bones and in the middle stages shorting the Radius is common. Often at the same time an additional procedure is done where they try to restore the blood supply to the lunate. This is a relatively new procedure, but it's having good results. In the later stages, where the lunate is no longer viable, wrist fusion or a PRC (Proximal Row Carpectamy) is common. A PRC is where they remove the lower row of wrist bones.
Chances are you won't be able to go back to any sort of work or activity that causes to much high impact on his wrist. I don't mean to sound negative, only realistic when I tell you that treatment may not work in the long run. Because of this you should do your best to protect your wrist against further injury. This means avoiding high impact activities, such as lifting heavy things, bowling, ect.
Kienbock Links
Workers Compensation Cases
Legal case from Arkansas: Ray MILLIGAN v. WEST TREE SERVICE
Legal Case from Illinois: ROBERT C. KOSHINSKI, JR. vs. DECATUR FOUNDRY
Legal case from Missouri: Edna Hubbert v. Boatmen's Bank
Legal case from Missouri: David Mireles v. Nordyne, Inc.
Legal case from Missouri: Peat Dickerson v. Bodine Aluminum
http://www.tsc.state.tn.us/PDF/tsc/workcomp/012/mcgjenni.pdf
http://www.supreme.state.az.us/opin/pdf98/cv970201.pdf
http://www.www.cis.state.mi.us/wkrcomp/wcac/97pdfa/26240966.pdf
http://www.cbs.state.or.us/external/wcb/year01/review/review01/feb/9809401b.pdf
http://www.cbs.state.or.us/external/wcb/year01/review/miscel01/jul/9907008.pdf
Legal case from North Carolina: Bruce Brown v. Family Dollar Distribution (multiple links to original case and appeal) http://www.comp.state.nc.us/ncic/pages/court/412695.htm
http://www.ncinsider.com/insider/appeals/appeals98/appeals0430/b_brown.html
http://www.aoc.state.nc.us/www/public/coa/opinions/1998/970306-1.htm
http://www.aoc.state.nc.us/www/public/coa/slip/slip98/970306-1.htm
Other Links
Lots of Articles about Kienbock Disease
Lydia's Kienbock Advice Page Great Link
On Site Information Excellent Link
http://www.medmedia.com/o11/209.htm
PubMed Search Another Excellent Link
Picture of MRI Showing Kienbock Disease
Localized Vascularized Bone Grafting Improves Healing of Difficult Hand Fractures
Eaton Hand - Invididual Clinical Pictures Page (Kienbock links listed below)
>h3>Radial Shortening for Kienbock Pictures (all MRI's or Xrays)
http://www.eatonhand.com/jph/JPH01209.htm
http://www.eatonhand.com/jph/JPH01209.htm
http://www.eatonhand.com/jph/JPH01211.htm
http://www.eatonhand.com/jph/JPH01212.htm
http://www.eatonhand.com/jph/JPH01213.htm
http://www.eatonhand.com/jph/JPH01214.htm
http://www.eatonhand.com/jph/JPH01216.htm
http://www.eatonhand.com/jph/JPH01217.htm
Vascular bone pedicle for Kienbock Pictures
(WARNING!!!! pictures JPH00358 and JPH000359 are actual surgical photos - do not view if you get faint at the site of blood)
http://www.eatonhand.com/jph/JPH00355.htm
http://www.eatonhand.com/jph/JPH00356.htm
http://www.eatonhand.com/jph/JPH00357.htm
http://www.eatonhand.com/jph/JPH00358.htm
http://www.eatonhand.com/jph/JPH00359.htm
http://www.eatonhand.com/jph/JPH00360.htm
http://www.eatonhand.com/jph/JPH00361.htmA number of David Dellucci articles on one page (baseball player with Kienbock):
