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Etiology of Kienböck Disease

Lluch, Alex MD*; Garcia-Elias, Marc MD, PhD

Techniques in Hand & Upper Extremity Surgery: March 2011 - Volume 15 - Issue 1 - p 33–37
doi: 10.1097/BTH.0b013e3182107329
Kienböck's Disease: The Past 100 Years and a Look at the Future, Edited by Dr. Gregory I. Bain: Invited Commentary

The etiology of Kienböck disease is still unknown and, consequently, the ideal treatment is in doubt. Many different hypotheses have been suggested. There are reasons to believe that there are mechanical, vascular, and metabolic factors predisposing to the disease, and probably some factors triggering the development of the process. Among mechanical factors, the short ulna has been thought to be the most relevant. However, presently there are insufficient data to support a significant association between negative ulnar variance and Kienböck disease. With regard to vascular factors, anatomical studies have shown consistent dorsal and palmar arteries entering the bone, and thus, the most likely site for vascular impairment may be at the subchondral level. Many triggering factors have been proposed during the past years, but until this is truly clarified, finding the real cause of Kienböck disease will continue to be a real challenge.

*Institut Kaplan, Hand Unit, Vall d'Hebron Hospital, Orthopaedic Surgery, Universitat Autònoma de Barcelona

Institut Kaplan, Barcelona, Spain

Supported by none.

Address correspondence and reprint requests to Marc García-Elías, MD, PhD, Institut Kaplan, Paseo Bonanova 9, 2-2, Barcelona 08022 Spain. e-mail:; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.