Kienböck’s disease is characterized as a condition involving avascular necrosis of the lunate bone, resulting in wrist-related problems. Both vascular and mechanical factors, as well as the ulnar’s shorter length compared to the radius, are considered significant etiological factors. The disease typically presents with pain in the central region of the wrist, which notably worsens with dorsiflexion of the middle finger. As the disease advances, additional pain may arise in the radioscaphoid joint. Kienböck’s disease relentlessly progresses, leading to wrist collapse and the development of advanced osteoarthritis. While initial radiological findings may be absent, subsequent manifestations can include lunate collapse, the formation of sclerotic regions, and fragmentation. MRI examinations are valuable for diagnostic purposes. Treatment options encompass arthroscopic capitate excision in the early stages, radial shortening and opening wedge osteotomy in the presence of ulnar shortening, and intercarpal fusions or vascular bundle implantation for more advanced cases. In instances of severe osteoarthritis, proximal row carpectomy and wrist arthrodesis may provide beneficial outcomes.
