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Three months ago I started having severe wrist pain and couldn't put any pressure on my wrist. The doctor put me in a cast and I was off work for a month. When this didn't change my pain, a bone scan and an MRI were done. This is how they found out I have Kienbock's. After another four weeks in a cast and then surgery, I'm still off work. Wouldn't it be better to just start with the surgery?

Kienbock's disease is the death of a bone in the wrist (the lunate) from a loss of blood supply. This condition is hard to see on X-rays and doesn't always show up well in other imaging studies. Early treatment is important and depends on accurate diagnosis. Immobilization in a cast is the first step. The hope is that this less invasive treatment will give the bone a chance to heal. There's still some debate among doctors about the best way to treat a more advanced case of Kienbock's. Surgery to restore the blood supply is often advised. The dead or dying bone is replaced with live bone that has a good blood supply. It may be necessary to revise the length of a bone in the forearm or to fuse the bones in the wrist. This is decided at the time of the operation when the doctor can see inside the wrist.

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