Houston Methodist. Leading Medicine

Wrist News

The Finger Bone's Connected to the...Wrist Bone

Have you ever heard of Kienböck's disease? Sounds like something you might get from eating too much German sausage! Actually, Kienböck's disease is the softening of a particular bone in the wrist called the lunate. This disease was first described 90 years ago by Dr. Kienböck.

The lunate bone is located in the very center of the wrist. This bone normally gets its blood supply from a very small artery. The blood vessel only enters the bone on one side. When injury--especially a break (fracture) in the lunate bone--occurs, blood to the area can be completely cut off. When this happens, the bone starts to die, a condition called avascular (without blood) necrosis (death).

Many different operations are used to treat this condition. No single method has been successful for all cases. One 20-year-old woman's year-long problem with right wrist pain and difficulty writing finally led her to see her doctor. She could not remember any specific injury. New scanning technology showed a small fracture in the lunate bone of her wrist.

A small piece of bone with a good blood supply was used to replace the dying bone. It was taken from the bone in the palm of the hand that connects with the index finger. After removing the dead part of the lunate, the replacement bone was carefully fitted into the remaining lunate bone. This way, the new bone could get a direct connection to the artery in that part of the wrist.

Other operations for this condition have reduced pain and improved movement, but the bone is often not repaired or restored. Moving a piece of bone with a good supply of blood to the center of the wrist is a new idea. It must be done when the damaged bone is still able to repair itself by receiving a new source of blood.


Michael P. Bengoechea-Beeby, MD, et al. Vascularized Bone Graft From the Index Metacarpal for Kienböck's Disease: A Case Report. In The Journal of Hand Surgery. May 2001. Vol. 26A. No. 3. Pp. 437-443.

12/18/2001

*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.
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