The anatomy and vascularity of the lunate: considerations applied to Kienböck’s disease

Kienbock Disease; the Length of Capitate and Third Metacarpal Bones

“…Since 1928 that Hulten published his classic study on relationship between ulnar variance and KD (14), the lunate overload in ulnar minus cases were the most popular theory in this context (15,16). However this theory was questioned by D'Hoore et al reviewing 52 patients with KD.…”

Kienbock’s disease, Avascular Necrosis of Lunate: A Clinico-anatomical Insight

“…Moreover, as the blood supply of the bone comes along with various ligaments including scapholunate interosseus ligament, lunotriquetral interosseus ligament and radioscaphocapitate ligament, any trauma or strain resulting in tear of these ligaments might disrupt the blood supply to the carpal . The etiology of the disease remains controversial [3,4] and involves biomechanical, traumatic, vascular and anatomical factors. These factors ultimately result in microfractures of the lunate trabecula.…”

“…It is a form of osteonecrosis characterized radiologically by sclerosis, cystic changes, fragmentation and articular surface collapse [3,4] . As the etiology of the condition is unknown and similar symptomatology is observed in scapholunate sprain, lunate fracture or lunate dislocation, the management becomes highly controversial posing a challenge to orthopaedic surgeons.…”

The Effect of Proximal Lunate Morphology “Zapico Classification” on Kienböck’s Disease

“…Some authors have suggested that the morphology and microstructure of the wrist bones, intraosseous pressure, and mechanical stresses have etiologic and prognostic values (3)(4)(5). Ulnar variance (UV) is a good example of many author's attempt to show that the negative UV is playing a key role (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), despite many normal individuals with a negative UV, that doesn't get KD (6) and many KD patients with positive UV (16). One of the theories that has repeatedly been proposed is the effect of lunate morphology in KD, either as an etiologic or a prognostic factor like Viegas and Zapico (15,17,18).…”