Kienbock's Disease - Predisposing Factors

Predisposing Factors

The exact cause of Kienbock's is not known, though there are thought to be a number of factors predisposing a person to Kienbock's.

Recent studies have made a correlation between Kienbock's sufferers and Western European ancestry, but no definitive link can be positively confirmed.

The necrosis of the lunate bone can frequently be traced to a trauma to the wrist, like a compound fracture, which could cause the lunate's blood supply to be interrupted. There has also been documentation showing that some people have only one artery supplying the lunate, which could be easily severed or pinched, even through a slight sprain, causing the patient to develop Kienbock's. Despite a preponderance of evidence, no particular etiology has been conclusively verified.

Data exists on the internet that most people suffering from Kienbock's are affected in their dominant hand, though about one-third of sufferers report the condition in their non-dominant hand.

Kienbock's disease is classified as a "rare disorder," meaning that it affects fewer than 200,000 people in the U.S. population.

Many Kienbock's patients are frustrated by the lack of consensus among hand surgeons about optimal treatments for Kienbock's. No matter what the disease's stage of progression, there is no one best treatment, and the decision is often based partially, or even mostly, on incidental factors such as the patient's pain tolerance, the patient's desire to return to active use of the hand (such as in manual occupations), and the surgeon's level of expertise with different treatments.

Though, since each case of Kienbock's is different, the makeup of the wrist and arm bones are important factors which are individualized to each patient. Therefore, one surgery will never be able to solve all the problems associated with the disease. Thus, no consensus can be reached among surgeons.