Pain and limited movement in the wrist can be a sign of Kienbock disease – when the lunate bone suffers trauma, it can suffer from a lack and even loss of blood supply, leading to the bone dying.
Without appropriate treatment, this disease can affect wrist mobility and strength.
Often, the best course of treatment for Kienbock disease is surgical, with a range of procedures available depending on the level and severity of the disease.
In this post, we look at post operative care and, in particular, what Kienbock surgery recovery entails.
Kienbock disease
Kienbock disease is a condition that affects the lunate bone in the wrist, with symptoms that can progress over time if left untreated.
When there is a lack of blood flow to the main lunate bone (which helps the wrist and hand to function), the bone in question will slowly begin to die. This can cause immeasurable discomfort and problems for individuals who are unable to carry out everyday tasks.
Symptoms of Kienbock can range from slight discomfort to decreased grip strength, limited wrist range of motion, swelling, a clicking or grinding sensation, and a sore wrist to the touch.
It is always recommended that if you do experience any of these symptoms, you seek professional diagnosis and treatment immediately.
Kienbock surgery
Surgery will be required for those suffering from Kienbock’s disease if:
- The bone has completely collapsed
- There is a significant loss of wrist function
- There is progressive bone damage apparent.
Surgical options for Kienbock disease can include:
Revascularisation – requires the moving of blood vessels from one part of the wrist to the lunate to promote better blood flow.
Joint levelling – this can take the form of lengthening or shortening the forearm bone, which in turn, will reduce pressure on the wrist.
Lunate excision – removing the problem bone completely from the wrist.
Intercarpal fusion – surgery involves joining the lunate bone to the adjacent carpal bone.
Proximal raw carpectomy – this surgical procedure is required when the lunate bone has collapsed entirely and now requires the removal of four out of the 8 bones in the wrist joint, making room for the wrist to regain mobility.
Benefits of surgery
- Reduce pain in the wrist
- Improve wrist function
- Stop the progression of the disease
- Increase grip strength
- Improve range of motion
- Patients can return to daily activities.
Kienbock’s surgery, recovery
Recovery from Kienbock treatment will take time and will be unique to each individual. The aim is to help you regain full strength and motion in your wrist by gradually learning to use it again for everyday activities.
Typically, complete recovery can take anywhere between 3 to 6 months.
Immediately after surgery
Following surgery, you will be required to wear a splint or cast for three to four months to help keep the wrist stable and allow the carpal bones and soft tissues to heal properly.
Ice packs can help reduce swelling, and anti-inflammatories can also help manage pain.
Immediately after Kienbock’s wrist surgery, the aim is to avoid putting pressure on the wrist to allow it the best possible chance at healing.
Throughout recover
You will require regular check-ups so your wrist specialist can ensure the wrist is healing as it should.
Check-ups can be in the form of physical examinations or X-rays to provide further detail and information to the specialist.
Regular check-ups are vital throughout Kienbock recovery, as they help spot infections sooner and even slow healing, ultimately allowing your wrist to be checked, keeping recovery on the right track.
Note: You may need to avoid activities that exacerbate wrist pain, and these will be discussed with you at your regular check-ups.
After the cast has been removed
Once the cast has been removed, rehabilitation and full hand therapy will begin.
Rehabilitation at this stage will involve gentle stretching and slow movements for a period of 3 to 4 months.
Light exercises will be introduced to reduce stiffness, prevent joint tightening, and boost blood flow.
Exercises and stretches are designed by professionals as we aim to keep things slow and safe and gradually build to increase strength and movement.
This may be in the form of strength-building exercises to help you get back to everyday activities where you may use resistance bands, weights, and hand tools to help rebuild muscle and endurance. These exercises also help improve fine motor skills and coordination, as well as boost confidence.
Kienbock’s recovery
Rehabilitation is a big part of recovery after Kienbock surgery, and it’s important to be consistent and active during your recovery with the aim of gaining long-term wrist health.
With the right treatment plan, tailored to the stage of the disease and the body’s response to treatment, patients can get back to all normal activities following focus and a commitment to rehabilitation.
At Ladan Hajipour, our specialist team is always on hand to support you with any wrist or hand problems. If you’re experiencing pain or discomfort in your hand or wrist, please book a consultation with us today.
You might interested to read the next article: Exercises and Physical Therapy for Kienbock Disease