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Keinbocks disease treatment

i have been diagnosed with keinbocks disease, and as part of my treatment i underwent an arthroscopic assessment, the results of this were that is 'significant fibrillation' and 'some loss of articular cartilage', there is also some 'slight migration of the wrist between the scapho-lunate gap'. I was told that the standard treatment of this condition was to do a 'radial shortening'. Unfortunatly in my case there is ' no negative ulnar varience' so this rules this form of treatment out. I have now been told that physiotherapy and seeing a 'pain consultant' is the way forward on my case. would you say that this is a suggested path to take, or are there better solutions?
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Avatar universal
Hi,
   How are you? Kienböck disease is a condition in which a one of the small bones of the hand near the wrist called the lunate dies.If the blood supply to a bone stops, the bone can die, a condition known as osteonecrosis. Kienböck's disease is osteonecrosis of the lunate. It usually affects the dominant wrist of men aged 20-40 years, but can effect women, but usually later than in men. The true natural history (what happens if we do not treat it) of this condition is not well understood.

Diagnosis is usually based on a suggestive history and physical exam, then xrays or MRI. In its early stages, Kienböck’s disease may be difficult to diagnose because the symptoms are so similar to those of a sprained wrist.

Treatment is by two methods conservative or medical management and surgical management.Because our best understanding of the disease is that it is related to loss of blood supply to the lunate, and because we know some patients can be cured if we can just avoid trauma and collapse, this is our first choice in the earlier stages, along with NSAID's and immobilization.

As you mentioned there is no negative ulnar variance proceedures like joint-leveling procedures, intercarpal fusions can be considered.
All the best.
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