A Case of Kienbock's Disease from Repetitive Contact Stress.
- Author:
Chul Ju KIM
1
;
Young Su JU
;
Hyoung June IM
;
Yae Won BANG
;
Young Jun KWON
Author Information
1. Department of Occupational and Environmental Medicine, Hallym University Scared Heart Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Kienbock;
Lunate;
Osteonecrosis;
Occupational disease
- MeSH:
Chronic Pain;
Glycogen Storage Disease Type VI;
Hand;
Humans;
Korea;
Lunate Bone;
Medical Records;
Occupational Diseases;
Osteonecrosis;
Sprains and Strains;
Videotape Recording;
Workplace;
Wrist
- From:Korean Journal of Occupational and Environmental Medicine
2011;23(3):343-349
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: Kienbock's disease, which is characterized by osteonecrosis of the lunate bone, causes progressive chronic pain and dysfunction of the hand and wrist. Even though occurrence of the disease was reported approximately 100 years ago and it is suspected to be work-related to some degree, the etiology has not been clearly discribed and the disease has rarely been considered as an occupation-related disease. As such, we submit this case as the first report of Kienbock's disease in Korea, with clinical findings, x-ray, MRI (magnetic resonance imaging) and strain index results along with a literature review. METHODS: The patient was carefully interviewed and her medical records were properly reviewed by the authors with her consent. The authors also visited her factory work site to inspect and videotape the working environment and to conduct an ergonomic evaluation with a strain index. RESULTS: Excessively repeated contact stress was found to be concentrated on her right hand and the environment was discovered to be hazardous from an ergonomic standpoint. The literature review revealed that heavy loads on the hand might be related to the cause or deterioration associated with Kienbock's disease. ; therefore, it is very likely that her disease is related to her work. CONCLUSIONS: There is much evidence to suggest that heavy workloads involving hand and wrist intensive tasks may cause and worsen Kienbock's disease. However, to date epidemiologic studies clarifying the etiology of the disease have not been sufficiently reported. Therefore, further research focusing on the etiology and prevention of the disease are required. In addition, practical guidelines for hand and wrist intensive tasks are needed to prevent disease development and worsening.
