Lunate dislocation results in displacement of rotation of lunate without causing any change in the position of other carpal bones. A fracture to the lunate may also be associated with injury to the TFCC. What is important to note is that the lunate fossa has a spherical shape and the scaphoid has an elliptical shape. A recent trauma may have occurred that plays some role in the lunate becoming avascular (without blood supply). Lunate fracture. The proximal row, laterally to medially, consists of the scaphoid, lunate, triquetrum and pisiform. Kienbock’s Disease occurs when one of the wrist bones named the lunate spontaneously loses its blood supply. Lunatomalacia or Kienbock’s Disease presents itself with wrist pain and tenderness over the lunate bone. In Kienböck's disease, the blood supply to one of the small bones in the wrist—the lunate—is interrupted. These bones are all connected by ligaments, making the wrist a very complex joint which is actually a collection of multiple joints. The lunate is the fourth most fractures carpal bone (following the scaphoid, triquetrum, and trapezium). A broken bone or dislocated joint can interrupt the blood flow to a section of bone. Pressing in over the lunate will be painful and tender. Another possibility is that in addition to the lunate fracture, you have also sustained a bone or ligamentous injury to the thumb itself. A Patient's Guide to Kienbock's Disease Introduction. Kienbock’s disease, also known as avascular necrosis of the lunate, is a condition in which the lunate bone, one of eight small bones in the wrist, loses its blood supply, leading to death of the bone. What is important to note is that the lunate fossa has a spherical shape and the scaphoid has an elliptical shape. The hand surgeon will perform a ‘scaphoid shift’ test, which attempts to determine whether or not the scaphoid and lunate bones are moving together correctly. The lunate is a central bone in the wrist that is important for proper movement and … As it progresses, the bone tissue can die and cause more pain, wrist immobility, and arthritis. There are 8 carpal bones: the scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezoid, and trapezium. The most frequently performed surgery is the Proximal Row Carpectomy, where the lunate, scaphoid and triquetrum are extracted. Without an adequate blood supply, the bone cells die, a process called "osteonecrosis." Without a blood supply, the lunate bone dies (avascular necrosis = AVN) and then eventually collapses. Lunate Dislocation. Limited or restricted wrist mobility. Also called osteonecrosis, it can lead to tiny breaks in the bone and the bone's eventual collapse. Swelling over the lunate bone on the back of the wrist. Treatment is thumb spica splint and orthopedic follow‐up. 1. This pain may then radiate up the wrist to the forearm. Wrist Carpal Bones. Both scaphoid and lunate bones move on the radius in their respective fossae. A Lunate dislocation is a rare case of traumatic wrist injury which must be attended immediately and repaired with proper lunate dislocation surgery. They often are not diagnosed initially and present delayed as lunate osteonecrosis, which is also known as Kienbock disease. Occasionally these ganglia can cause pain, and may require curettage and bone grafting (9, 10, 11). At this point, the lunate is ready for removal. It’s located towards the center of the wrist. Lunatomalacia may result from repetitive injury to … Dislocation or displacement of the lunate bone can compress the median nerve and lead to CTS; attention should focus on this carpal bone. In summary, we describe a case of lunate fracture, which might have gone undiagnosed without cross-sectional imaging. In Kienböck's disease, the blood supply to one of the small bones in the wrist—the lunate—is interrupted. The scaphoid and lunate bones are particularly susceptible to avascular necrosis, especially following fractures. Arthritis Kienböck’s disease, is a rare, debilitating condition that can lead to chronic pain and dysfunction. Kienbock's disease is a condition in which one of the small bones of the wrist loses its blood supply and dies, causing pain and stiffness with wrist motion.
Scapho-Lunate Ligament injuries lead to pain on the back (dorsum) of the wrist that is worse with activities, especially when putting pressure on the extended wrist, such as when doing a push-up, getting up off of the floor, getting out of a pool, or opening a door. Because the other carpal bones overlap the lunate bone, a fracture may be difficult to identify on plain radiographs and may require CT or MRI to confirm.
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