Kienböck's disease: the natural history of Kienböck's disease and consideration of lunate fractures.

Forty-six patients with Kienböck's disease were evaluated over a 2- to 27-year period; 72% had a history of wrist injury prior to diagnosis; 67% had evidence of fracture or fragmentation of the lunate. Documented fractures of the lunate were identified followed by both the presence and absence of subsequent Kienböck's disease and this may be explained by the variable blood supply of the lunate. Ten patients were not treated; 36 patients were treated surgically. Patients were relieved of pain and had functional wrists whether they were treated or not and regardless of the type of surgical treatment.