Have you ever heard of something called KienbÃ¶ck disease in children? I think it's rare but it's something my grandson has developed and I'm very concerned. Is it life-threatening?
Kienbock's disease is very rare in children though there are some individual reports among teenagers. It is a condition in which one of the small bones of the wrist (the lunate) loses its blood supply and dies, causing pain, swelling, and stiffness with wrist motion.
In the late stages of the disease, the bone collapses, shifting the position of other bones in the wrist. This shifting eventually leads to degenerative changes and osteoarthritis in the joint. It is not a life-threatening condition but it can create some problems.
Bone sclerosis (hardening), fracture, collapse, and arthritis are just a few of the things that can happen with this disease. The patient suffers from pain, loss of motion, and loss of function sometimes leading to disability.
In adults with KienbÃ¶ck disease, the natural history (what happens over time) is not fully known or understood. For example, some people have severe symptoms with mild disease labeled stage 1 disease. Others can have no symptoms despite severe (stage 4 disease). And it is possible to have many different combinations in between those two extremes.
Treatment can range from conservative (nonoperative) care to any one of a number of surgical procedures. But the results are usually pretty good with relief of the painful symptoms and restoration of near normal strength and function of the wrist and hand. Of course, since there are so few cases among children and teens, all we have to rely on are case studies.
But younger patients who have not reached full bone (skeletal) maturity actually have some advantages over older adults with this condition. The body is still producing new bone growth and this can aid in recovery. The prognosis for your grandson is likely very good but you will have a better idea of what to expect once the surgeon has fully evaluated him and started treatment. Please let us know how he does!
If you would like more information on KienbÃ¶ck disease in general, you can read our Patient Guide to KienbÃ¶ck Disease.
Kevin Lutsky, MD, and Pedro K. Beredjiklian, MD. KienbÃ¶ck Disease. In The Journal of Hand Surgery. September 2012. Vol. 37A. No. 9. Pp. 1942-1952.
*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.