Advice for Newly Diagnosed Kienbock Patients
Disclaimer: This information is not intended to replace the advice of a qualified medical professional. It is based solely on the experience of other Kienbock's patients.
Listen to the pronunciation of the word Kienböck
1) Seek out an orthopedist (or possibly a plastic surgeon) who specializes ONLY in hands and upper extremities (arm and shoulder). The hand is very complicated and Kienbock’s is an unusual disorder. You need a specialist. Check out your doctor’s background and training. He/she should have a certificate of added qualification in hands from the American Board of Orthopedic Surgery (or American Board of Plastic Surgery).
Click on the "Find a Surgeon" link on the American Society for Surgery of the Hand web site for help in locating a hand surgeon in your city.
2) Get a second opinion. There is no definitive treatment for Kienbock’s so get another opinion about how your case should be handled.
3) Educate yourself by first reading all the articles available via the Kienbock's group on the internet. Make sure you read the abstracts of medical papers available from PubMed (aka Medline). Next, head to your local medical library if one is available. By understanding your disorder you will be able to make an educated decision regarding the treatment options offered to you.
4) Treat your hand gently by not performing any stressful or straining activities. The vascularity of the lunate is in a tenuous state when you have Kienbock’s. There is no need to aggravate the situation by over using your wrist. If the doctor puts you in a splint or cast this does not mean your wrist is completely protected - you still need to be careful. Many doctors say that finger motion (such as typing) is okay but check with your doctor.
5) As a diagnostic tool an MRI is much more accurate than an x-ray in the early stages of Kienbock’s. If you have not had an MRI, ask your doctor about having one done.
 MRI showing Kienbocks (click on image to enlarge)
Lunate is the blackened bone near the center of each image
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6) In the early stages of Kienbock’s (stage I-II) it is sometimes possible that the conservative non-surgical option of casting can be successful. Additionally, some doctors are trying casting in combination with electrical stimulation. Discuss with your doctor whether he/she thinks a non-surgical approach could work in your case.
Please send comments or suggestions concerning this page to:lkedzierski@yahoo.com
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This page was last-updated February 7, 2000
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