Kienböck Disease

Description

Kienböck Disease: Avascular necrosis (osteonecrosis) of the lunate leading to abnormal carpal motion


History

1910 – Kienböck published his article on traumatic malacia of the lunate, providing the earliest description of avascular necrosis of the lunate. He presented 16 of his own cases and presented his views on pathogenesis and treatment. He described isolated disease of the lunate associated with only slight secondary changes in other carpal bones. Clinical examination revealed limited active wrist motion and pain on passive movement.

Kienböck believed that the cause of the disease was a disturbance in the nutrition of the lunate caused by the rupture of ligaments and blood vessels during contusions, sprains, or subluxations. He proposed that fractures seen on X-Ray occurred after the lunate had been weakened by ligament and blood vessel rupture.

1925 – Goldsmith reported the first cases of Kienböck disease in the American literature as fractures of the lunate in the absence of a history of trauma.


Associated Persons


Alternative names

  • Kienböck syndrome
  • Kienboeck or Kienbock disease

Controversies

Multiple sources cite JL Peste with the original description of lunate osteonecrosis. However closer inspection of the 200 word Society minutes is warranted.

Peste presented the clinical case of an individual suffering major trauma following a four story fall and the resultant autopsy findings. These included a comminuted compound skull and face fractures; wrist dislocation and a ‘double-fracture‘ of the lunate.

Very likely an early description of lunate fracture, but not the first description of Kienböck disease.

Peste 1843 – la semi-lunaire, était le siege aussi d’une double fracture
Peste 1843 – la semi-lunaire, était le siege aussi d’une double fracture

References


eponymictionary CTA

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the names behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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