Three months ago I started having severe wrist pain and couldn't put any pressure on my wrist. The doctor put me in a cast and I was off work for a month. When this didn't change my pain, a bone scan and an MRI were done. This is how they found out I have Kienbock's. After another four weeks in a cast and then surgery, I'm still off work. Wouldn't it be better to just start with the surgery?
Kienbock's disease is the death of a bone in the wrist (the lunate) from a loss of blood supply. This condition is hard to see on X-rays and doesn't always show up well in other imaging studies.
Early treatment is important and depends on accurate diagnosis. Immobilization in a cast is the first step. The hope is that this less invasive treatment will give the bone a chance to heal. There's still some debate among doctors about the best way to treat a more advanced case of Kienbock's.
Surgery to restore the blood supply is often advised. The dead or dying bone is replaced with live bone that has a good blood supply. It may be necessary to revise the length of a bone in the forearm or to fuse the bones in the wrist. This is decided at the time of the operation when the doctor can see inside the wrist.
David J. Ingle, DO, et al. Early Detection of Kienbock's Disease With MRI Treated By Revascularization With a Distal Radius Bone Graft. In Orthopedics. January 2003. Vol. 26. No. 1. Pp. 91-93.
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