Treatment options in Kienböck's disease.

Kienböck’s disease or lunatomalacia is an aseptic osteonecrosis of the lunate bone initiating a progressive collapse of the lunate bone, followed by total carpal collapse. The first description was made one hundred years ago (107). Thus far, its exact cause and natural history remain unknown (44). Several extrinsic and intrinsic factors have been investigated as to their role in the aetiology of the bone necrosis. Kienböck’s disease is a slowly progressive disorder with well recognised stages leading to various treatment options. However, little is known about their effectiveness, mainly because Kienböck’s disease is not very common and a long follow-up is needed to evaluate the ultimate outcome (1,84).