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Handchir Mikrochir Plast Chir 2010; 42(3): 171-176
DOI: 10.1055/s-0030-1249611
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Classification and Treatment of Kienböck's Disease: A Review of the Past 100 Years, and a Look at the Future

Klassifikation und Behandlung des Morbus Kienböck: Eine Übersicht über die vergangenen 100 Jahre und ein Blick in die ZukunftN. Lesley1 , D. Lichtman1
  • 1John Peter Smith Hospital, University of North Texas Health Science Center, Orthopedic Surgery, Fort Worth, Texas, USA
Further Information

Publication History

received 16.11.2009

accepted 12.2.2010

Publication Date:
05 May 2010 (online)

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Abstract

In the century since it was first described, much has been learned about Kienböck's disease. However, despite advances in diagnosis and treatment, questions remain regarding the etiology of this condition. In this discussion, we will review the history and rationale for the current classification system, along with our current treatment algorithm. Additionally, we will discuss emerging classification systems based on new technology that enhances the understanding of Kienböck's disease. With consideration of this new information, we will propose new stages of this condition, and speculate on how these new stages may affect the future of Kienböck's disease.

Zusammenfassung

In den hundert Jahren seit der Erstbeschreibung der Lunatumnekrose durch Kienböck wurde vieles über die Erkrankung hinzugelernt. Trotz aller Fortschritte in Diagnostik und Behandlung bleiben jedoch Fragen, insbesondere zur Ätiologie der Erkrankung. Die vorliegende Arbeit gibt eine Übersicht über Geschichte und Hintergrund der aktuell gängigen Klassifikation und unser darauf aufgebautes Behandlungsregime. Basierend auf neuen Beobachtungen schlagen wir eine Erweiterung des Klassifikationssystems um neue Stadien vor und deren mögliche Auswirkungen für die Zukunft.

Key words

Kienböck's disease - lunate - Osteonecrosis - lunatomalacia

Schlüsselwörter

M. Kienböck - Lunatum - Osteonekrose - Lunatumnekrose

References

  • 1 Peltier LF. The classic. Concerning traumatic malacia of the lunate and its consequences: Degeneration and compression fractures. Privatdozent Dr. Robert Kienböck.  Clin Orthop Relat Res. 1980;  149 4-8
    Google Scholar
  • 2 Lee M. The intraosseous arterial pattern of the carpal lunate bone and its relation to avascular necrosis.  Acta Orthop Scand. 1963;  33 43-55
    Google Scholar
  • 3 Gelberman RH, Bauman TD, Menon J. et al . The vascularity of the lunate bone and Kienböck's disease.  J Hand Surg [Am]. 1980;  5 272-278
    Google Scholar
  • 4 White Jr. RE, Omer Jr. GE. Transient vascular compromise of the lunate after fracture-dislocation or dislocation of the carpus.  J Hand Surg [Am]. 1984;  9 181-184
    Google Scholar
  • 5 Schiltenwolf M, Martini AK, Mau HC. et al . Further investigations of the intraosseous pressure characteristics in necrotic lunates (Kienböck's disease).  J Hand Surg [Am]. 1996;  21 754-758
    Google Scholar
  • 6 Braun RM. Pronator pedicle bone grafting in the forearm and proximal carpal row.  Orthop Trans. 1983;  7 35
    Google Scholar
  • 7 Erbs G, Bohm E. Langzeitergebnisse der os pisiforme–Verlangerung bei mondbeinnekrose.  Handchir Mikrochir Plast Chir. 1984;  16 85
    Google Scholar
  • 8 Hori Y, Tamai S. Blood vessel transplantion to bone.  J Hand Surg [Am]. 1979;  4 23
    Google Scholar
  • 9 Tamai S, Yajima H, Ono H. Revascularization procedures in the treatment of Kienböck's disease.  Hand Clin. 1993;  9 455
    Google Scholar
  • 10 Lichtman DM, Mack GR, MacDonald RI. et al . Kienböck's disease: The role of silicone replacement arthroplasty.  J Bone Joint Surg [Am]. 1977;  59 899-908
    Google Scholar
  • 11 Luo J, Diao E. Kienböck's disease: An approach to treatment.  Hand Clin. 2006;  22 465-473 ; abstract vi
    Google Scholar
  • 12 Goldfarb CA, Hsu J, Gelberman RH. et al . The Lichtman classification for Kienböck's disease: An assessment of reliability.  J Hand Surg [Am]. 2003;  28 74-80
    Google Scholar
  • 13 Hultén O. Über anatomische Variationen der Handgelenkknochen.  Acta Radiol Scand. 1928;  9 155-168
    Google Scholar
  • 14 Simmons SP, Tobias B, Lichtman DM. Lunate revascularization with artery implantation and bone grafting.  J Hand Surg [Am]. 2009;  34 155-160
    Google Scholar
  • 15 Schmitt R, Krimmer H. Osteonecrosis of the hand skeleton. In: Schmitt R, Lanz U, eds. Diagnostic Imaging of the Hand. 1st edn. Stuttgart, New York: Georg Thieme Verlag; 2007: 351-364
    Google Scholar
  • 16 Chen YC. Arthroscopy of the wrist and finger joints.  Orthop Clin North Am. 1979;  10 723-733
    Google Scholar
  • 17 Bain GI, Munt J, Turner PC. New advances in wrist arthroscopy.  Arthroscopy.. 2008;  24 355-367
    Google Scholar
  • 18 Bain GI, Begg M. Arthroscopic assessment and classification of Kienböck's disease.  Tech Hand Up Extrem Surg. 2006;  10 8-13
    Google Scholar
  • 19 Schmitt R, Heinze A, Fellner F. et al . Imaging and staging of avascular osteonecroses at the wrist and hand.  Eur J Radiol. 1997;  25 92-103
    Google Scholar
  • 20 Lichtman DM, Alexdander AH, Mack GR. et al . Kienböck's disease – Update on silicone replacement arthroplasty.  J Hand Surg [Am]. 1982;  7 343-347
    Google Scholar

Correspondence

Nathan Lesley

Orthopaedic Surgery

John Peter Smith Hospital

University of North Texas

Health Science Center

1500 S Main

Fort Worth

76104 Texas

USA

Email: st_nlesley@hotmail.com

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