Lunatum malacia – causes, symptoms & therapy

Lunatummalazie

Lunatum malacia , which is also often called moon leg death, Kienböck’s disease or lunar necrosis, is what doctors call a disease of the carpal bones. In the case of lunate malacia, the os lunatum – the lunar bone – dies off completely or partially. The disease itself is divided into different stages, all of which bring different symptoms.

What is lunate malacia?

In lunate malacia, the patient suffers from progressive decay of the lunar bone. The lunate bone is a small bony trabeculae located in the wrist. The reason for the necrosis is reduced blood flow to the affected area. There are eight carpal bones in total in the human hand.

The Os lunatum, which is also repeatedly called the lunar bone, is one of the most important carpal bones. This is right in the middle of the wrist. Due to the lunate malacia, the bone trabeculae die off partially or completely. Lunatum malacia mainly affects people between the ages of 20 and 40. Statistically, men are affected twice as often as women.

causes

The causes of lunate malacia are not yet 100 percent clear. However, the disease itself has been known for around 100 years. The doctor at the time, Kienböck, already suspected when the lunate malacia developed that it was a circulatory disorder that ultimately caused the symptoms. There are many reasons why this circulatory disorder occurs. Doctors mainly assume a lack of blood circulation, which is due to the predisposition.But a fracture of the lunar bone can sometimes lead to reduced blood flow and lunate malacia. It is also possible that a corresponding lunate malacia can occur due to an incorrect or pressure load on the lunar bone (with frequent use with the jackhammer). There are also patients who have a relatively short ulna. The disproportion that exists between the ulna and radius can subsequently also cause reduced blood flow – and thus lunate malacia.

symptoms and course

Typical symptoms of lunate malacia:

  • power loss

Patients suffering from lunate malacia mainly complain of hand pain. The patients also suffer a loss of strength in the affected hand and have restricted movement of the wrist. If the disease is already advanced, the entire wrist will hurt. Swelling also occurs; movement is becoming increasingly restricted.

The doctor divides the lunate malacia into four stages. The stages provide information about how severe the damage to the lunar bone is. If the disease is already advanced, neighboring carpal bones can also be affected by lunate malacia, so that deformities also occur here.

Diagnose

The doctor first takes an X-ray . However, an X-ray cannot tell if the patient has early stages of lunate malacia. X-ray images only give an insight into how severe the disease is in the further stages. Other diagnostic options are magnetic resonance imaging and computed tomography . A physical examination is also carried out.

At the latest when the patient complains of pain in the wrist or believes that it keeps swelling, the doctor tries – by means of a pressure test – to determine whether the lunar bone is damaged. Since the pain of lunate malacia is often reminiscent of tendonitis , the physician must be careful when localizing the pain. Basically, with lunate malacia, pain occurs directly on the lunar bone, while the tendonitis radiates and several regions on the arm or hand are sensitive to pain.

complications

Lunatum malacia primarily causes relatively severe pain in the hand. This pain can radiate to the fingers or the back of the hand and cause discomfort there. Many patients suffer from insomnia due to the pain – irritability , depressive moods and exhaustion can be the result. The muscle weakness in the affected hand leads to restricted movement and functional disorders, which can lead to various problems in the patient’s everyday life.

Swelling or bruising can also occur. In most cases, lunate malacia can be treated without complications. Nevertheless, a surgical procedure always involves certain risks that must be taken into account. This can lead to nerve and tissue injuries or inflammation.

People with allergies are at risk of a severe allergic reaction or even anaphylactic shock . The painkillers used are usually quite strong and cause fatigue, poor concentration and other problems. Permanent damage to the internal organs, especially the kidneys, liver and heart, cannot be ruled out.

treatment and therapy

Ultimately, the stage at hand determines which therapy the patient receives. First the doctor tries to stop the disease in the stage it is in. Thus, the therapy primarily consists in preventing the progression of the disease. These chances are relatively good unless the patient is already in the last stage of lunate malacia. At the beginning of the disease, a joint reflection often helps. The doctor can thus examine and assess the affected joints and hand bones.

Tissue removal, which is also carried out, is intended to relieve the bone. After that, the bone can rebuild and enjoys more space – due to the removal of the tissue. If there is already a very severe clinical picture, it is necessary for the doctor to remove bone material from the pelvis so that the carpal bone can be filled up.If the cause is the shortened radius or ulna, an operation is also necessary. Here the bone is artificially lengthened or shortened. Other surgical methods include severing the nerve fibers to prevent pain conduction. If no operation or treatment brings the desired success, the doctor has to stiffen the wrist. With each method or therapy, physiotherapy and a splint are prescribed.

prevention

Lunatum malacia can only be prevented if various overloads or incorrect loads are prevented or avoided. Prevention is not possible if the patient has a congenital circulatory disorder or a shortened ulna.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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