Wednesday, September 28, 2022

Is Kienbock’s Disease A Disability

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Kienbocks Disease Surgery Recovery Time

Kienbock’s Disease and working out Q& A

If you have surgery for Kienbocks disease, you will wear a splint for three or four months. Then you will revisit your surgeon to monitor the healing of your wrist bones. If your wrist heals well and does not require any follow-up adjustments, then you will do physical therapy for another three or four months. This will help you to regain strength and motion throughout your wrist. Without the pain from your Kienbocks disease, you can return to your daily

What Are The Symptoms Avascular Necrosis

  • Aseptic necrosis begins as a painless bone abnormality. It can remain painless.
  • The involved bone often later develops pain, especially with use.
  • Pain in the affected joint is usually the first symptom of avascular necrosis.
  • When the lower extremity is affected, this can lead to a limp during walking.
  • If the hip is affected, groin pain is common, especially when walking. As the ball of the hip collapses with progression of avascular necrosis of the hip, pain can persist in the hip after rotation or weight-bearing with walking.

Diagnosis Of Kienbock’s Disease

The diagnosis of Kienbocks disease can often be made by reviewing your history, performing a physical examination, and taking x-rays. In the early stages of this disease, the x-rays may be normal and other tests are needed to confirm the diagnosis. Most likely, the most reliable test to assess the blood supply of the lunate is Magnetic Resonance Imaging . CT and bone scans may also be used.This is a slow-progressing disease, and patients often have the condition for months or even years before they seek treatment. It can be difficult to diagnose in its earlier stages.

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What If I Don’t Meet The Listing Requirements

You can still win your disability claim even if you don’t meet the above listing requirements. A disability examiner who works for Social Security will decide, based on the medical evidence you have provided, whether you can still do your old job. If the examiner believes you can still perform your past work, your claim will be denied if, on the other hand, the examiner agrees that you can no longer do your old job, the examiner will determine whether there is any other work you could do.

To make this determination, the examiner will review all the medical evidence you have provided in support of your claim and prepare a Residual Functional Capacity assessment . An RFC details how your avascular necrosis has affected your ability to perform certain job-related functions. For example, if the avascular necrosis has damaged the joints in your dominant hand so that you can no longer write or hold a pen, your RFC would reflect extreme limitations in your ability to perform fine motor skills. Without the use of your dominant hand, it would be difficult for you to perform most secretarial work. It would also be hard for you to perform sorting or assembly jobs that require manual dexterity in both hands.

If you are limited to lifting and carrying objects that weigh less than 10 pounds, you would be unable to perform almost all jobs. Necrosis in your hips and knees may also prevent you from kneeling or stooping. The complete inability to stoop usually results in a disabled finding.

How Does Kienbocks Disease Progress

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Progression is varied and unpredicatable. It may be diagnosed in the early stage, when you may only experience pain and swelling, but with normal x-rays. Changes in the lunate become more apparent as the disease progresses.

As it progresses, the lunate develops small fractures and collapses. The mechanics of the wrist change, putting abnormal stress and wear on the joints within the wrist. Be aware that not every case progresses through all stages to the severely arthritic end-stage.

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Wrist & Hand Fracture

If you have shooting pain in your hand or wrist, you may have a wrist or hand fracture. Fracturing, or breaking, the bones in the wrist or hand is extremely easy because of their size and structure. Read on to learn how wrist and hand fractures are treated by Dr. Patel and the Atlanta Hand Specialists.

Getting Help With Your Avascular Necrosis Ssd Application

Whether you meet the SSAs listing for dysfunction of a joint or a bone fracture, or need to prove youre disability under a medical vocational allowance, you must work closely with your doctor to ensure your medical records are thorough and that your application and associated documentation meet the SSAs evidence requirements for SSD eligibility.

Working with a Social Security attorney or advocate in putting together your application can also increase your chances of being approved for SSD benefits without delays. If necessary, your attorney or advocate can also assist you in compiling information and completing other required forms, and in preparing for and testifying at an appeal hearing, if one is required.

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Is Kienbock’s Disease Curable

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Keeping this in view, how rare is Kienbock’s disease?

Kienböck’s disease is classified as a “rare disorder,” meaning that it affects fewer than 200,000 people in the U.S. population. Many Kienböck’s patients are frustrated by the lack of consensus among hand surgeons about optimal treatments for Kienböck’s.

Additionally, can you die from Kienbock’s disease? If blood supply is cut off to body tissue, oxygen and nutrients cannot reach the tissue, and it will die. This is necrosis. Kienböck’s most commonly affects people aged from 20 to 40 years of age, and it occurs in men more often than in women. It rarely happens in both wrists.

Beside above, what is the treatment for Kienbock’s disease?

Nonsurgical TreatmentIn the very early stage of the disease, pain and swelling may be managed with anti-inflammatory medications, such as aspirin or ibuprofen. Immobilizing your wrist for a period of time can help relieve pressure on the lunate, and your doctor may recommend splinting or casting for 2 to 3 weeks.

What is Kienbock disease?

Kienbock’s disease, also known as avascular necrosis of the lunate, is a condition in which the lunate bone, one of eight small bones in the wrist, loses its blood supply, leading to death of the bone. Damage to the lunate can lead to pain, stiffness, and sometimes arthritis of the wrist if some time has passed.

What Is Kienbocks Disease

Kienbock’s Disease – Everything You Need To Know – Dr. Nabil Ebraheim

In Kienbocks disease the lunate bone loses its blood supply, gradually killing the bone. This has big ramifications for your hand, because this particular bone plays a big role in your mobility. The lunate works with bones in your forearm to direct your wrists motion.

People who suffer from Kienbocks, which is most popular among young adult men, can experience pain and stiffness as a result of the disease. If not treated, the lunate bone can collapse in your wrist. That leads to irritation, as the bone rubs unnaturally against your wrist tendons.

The collapse of the lunate bone causes the other seven bones in your wrist to support the joint, which can lead to further problems.

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How Is Kienbocks Disease Diagnosed

Most patients with Kienbocks diease experience wrist pain and tenderness directly over the lunate bone. Dr. Patel can diagnose the disease by evaluating your history, and performing a physical evaluation, with x-rays.

In some cases special tests are needed to confirm the diagnosis. An MRI is the most reliable way to study to assess the blood supply of the lunate. A specialized CT scan or a bone scan may also be used.

What Causes Avascular Necrosis

While the precise mechanism for the development of avascular necrosis is not known, it is suspected that interruption of the blood supply to the affected bone plays some role. This can occur when traumatic impact injures the blood vessels to the bone or when diseases produce areas of abnormal circulation.

There are many causes of avascular necrosis, but the vast majority of avascular necrosis is caused by either traumatic injury to the affected bone , steroid medication usage , or excessive alcohol consumption.

Other risk factors for developing avascular necrosis include cigarettesmoking, pregnancy, radiation and chemotherapy treatments, bone marrow and blood diseases , and underwater diver’s disease . Avascular necrosis occurs more frequently in patients with certain underlying diseases, including systemic lupus erythematosus, diabetes mellitus, vasculitis, and inflammatory bowel disease.

It is currently suspected by some researchers that intravenous bisphosphonate medications, including zoledronate and pamidronate , which are used to reduce elevated calcium levels in patients with cancer and to treat osteoporosis, may increase the risk of avascular necrosis of the jaw bone. Ironically, bisphosphonates are actually used by some to treat the bone pain and decrease disability in patients with avascular necrosis.

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Types Of Disability Benefits

SSA generally offers two types of benefits for the disabled: Social Security Disability Insurance and Supplemental Security Income . SSDI is based on the credits from the work that you have done in your life while SSI is a need based program. You must be found disabled under SSAs Five Step Sequential Evaluation before you are entitled to either benefit.

How Rare Is Kienbock’s Disease

Figure 1 from Kienbock

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Similarly, it is asked, how common is Kienbock’s disease?

Kienbock’s disease is most common in men between the ages of 20 and 40 and rarely affects both wrists.

One may also ask, is Kienbock’s disease work related? Kienböck’s disease is an osteonecrosis involving the lunate bone that finally results in carpal collapse and severe wrist arthrosis. Traditionally KD is recognized as an occupational disease caused by hand-arm vibration or by trauma in workrelated injuries .

Likewise, people ask, is Kienbock’s disease curable?

There is no complete cure for Kienbock’s disease, but there are several nonsurgical and surgical options for treatment. Treatment options depend on the stage of the disease , as well as the patient’s age, hand dominance, and ability to function.

How do you get Kienbock’s disease?

The exact cause of Kienbock’s disease is unknown. It’s often associated with an injury to your wrist, such as a fall, that affects blood supply to your lunate. It also is associated with repetitive micro-injuries to your wrist, such as from jackhammer use.

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What Are Risk Factors For This Condition

Risk factors are:

  • Differences in the length and shape of your forearm bones, the radius, and the ulna. This can put more pressure on your lunate.
  • Only one blood vessel supplying blood to your bone, instead of the usual two. This can affect blood supply to your bone.
  • Other diseases, such as lupus, sickle cell anemia, cerebral palsy, and diseases that affect blood supply, are associated with Kienbocks disease.

Kienbocks disease occurs most commonly in men between 20 and 40 years old. Youre also at an increased risk if you regularly do heavy manual labor.

If you have persistent wrist pain, its important to see a doctor to find out the cause. Early diagnosis and treatment of Kienbocks disease can lead to a better outcome.

In an early stage of the disease, you may be able to relieve pain with conservative treatment.

If Kienbocks disease isnt treated, your lunate bone will continue to deteriorate. This could lead to severe pain and loss of movement in your wrist.

The Stages And Symptoms Of Kienbocks

How do you know if you have Kienbocks? The common symptoms are pain and limited motion in your wrist. The pain can be severe or mild, and constant or occasional. For many with Kienbocks, discomfort might occur only after intense motion. You may have the disease for years before the tenderness in your wrist becomes severe.

This disease is understood in four stages, and those stages help surgeons determine the best course of treatment for your wrist:

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Disability Benefits For Avascular Necrosis

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Avascular Necrosis is sometimes referred to by the terms Aseptic Necrosis or Osteonecrosis. It is a disorder of microcirculation within the bone that causes the involved portion of the bone to die . It can affect any bone in the body. When it occurs, it causes collapse of the bone, and when that’s close to a joint, the nearby joint also collapses, with the development of degenerative arthritis in that joint.

The hip is the most common area for AVN, followed by the knee, shoulder, ankle, elbow and wrist. When AVN occurs in a vertebral body, it is called Kummel’s disease. AVN can also occur in the jawbone related to treatment for osteoporosis with medications such as Fosamax, Boniva, Reclast, and Prolia. No one knows why that happens.

Cause

The exact cause of AVN is not known. However, it has been associated with injury , corticosteroid medications , smoking, alcohol, pregnancy, radiation, chemotherapy, leukemia, lupus, diabetes, inflammatory bowel disease , and Caisson’s disease from rapid decompression. All these conditions appear to disrupt the normal microcirculation inside a bone that then leads to the development of AVN.

Symptoms

AVN affects both men and women, usually in the 30-50 age group. It is a relatively rare condition, with approximately 10,000 to 20,000 Americans affected on a yearly basis.

Diagnosis

X-rays and imaging studies is how the diagnosis of AVN is usually established.

Medical Documentation To Prove Avascular Necrosis

Kienbocks Disease Update (wrist surgery and recovery)

No matter how your application for SSD benefits will be reviewed and potentially approved by the SSA, there are certain pieces of documentation which must be included in your supporting documentation in order for you to see a favorable outcome. These include:

  • Thorough medical records, including notes from your physical exams detailing your symptoms and the frequency in which they occur
  • the duration of hospitalization or other required medical interventions, therapies or treatments
  • the types of medications you take, dosages for each and the effect theyve had on your symptoms
  • detailed statements from your treating physician describing the severity of your symptoms and the prognosis in your case
  • Imaging and other test results that formally document the diagnosis and the progression of the illness

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What Treatment Options Are Available

Treatment for Kienbocks disease depends on the severity of pain and the stage of lunate deterioration.

In an early stage of Kienbocks disease, your doctor may prescribe anti-inflammatory drugs to relieve pain and swelling. Immobilization of your wrist may take pressure off the lunate and help restore the flow of blood to the bone. Your doctor may advise putting your wrist in a splint or cast for 2 or 3 weeks to keep it immobile.

Physical therapy can also help to improve the range of motion in your wrist. A physical therapist can assess your wrist and provide an exercise routine to help maintain your wrist use.

If you have more pain or the lunate is deteriorated, your doctor may advise surgery. There are several options available, depending on the degree of damage.

Kienbocks Disease: Causes Symptoms And Treatment

Disclaimer: Results are not guaranteed*** and may vary from person to person***.

Those who depend on their hands for a living understand the importance of healthy wrist bones. But, some people, through no fault of their own, contract a rare and possibly disabling condition known as Kienbocks disease. We will take a closer look at exactly what Kienbocks disease is, the symptoms, and treatments.

Kienbocks disease occurs when the lunate bone in the wrist suffers damage due to limited blood flow. This tiny bone is one of the eight carpal bones, and is essential for movement and support of the wrist joint. As with all bones and tissue, proper functioning is dependent upon a continuous supply of oxygenated blood. Without this nourishment, osteonecrosis occurs and the bone eventually dies.

Kienbocks disease is seen more frequently in men and those between 20 and 40 years of age. It is also known as osteocronosis of the lunate and avascular necrosis of the lunate.

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What Are The Causes And Symptoms Of Kienbocks Disease

To date, no one cause has been identified for Kienbocks disease. However, there are several factors experts have linked to the condition.

  • Injury or trauma directly to the wrist
  • Collapse of lunate bone

Depending on the severity and stage of the symptoms, cortisone injections may be used.

4. Physical Therapy

To maintain range of motion, treat pain, and avoid loss of use of wrist, specific physical therapy exercises can be done.

The lunate bone will need to be regularly checked for any signs of the disease progressing every four to six weeks for the first year.

What Is The Treatment For Avascular Necrosis

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The treatment for avascular necrosis includes:

  • Avoiding injury to bone that is affected by avascular necrosis is the first line of treatment.
  • This can include non-weight-bearing , etc. when a weight-bearing joint is involved.
  • The aim is to attempt to preserve the affected joint and avoid joint replacement, when possible, especially in young individuals.
  • Treating any underlying cause of avascular necrosis and management of underlying diseases is essential to minimize progression of disease and to prevent involvement of other bones.
  • Bisphosphonate medications, such as alendronate , have been shown to reduce bone pain and improve function in patients with avascular necrosis.
  • Additionally, medications to lower blood fats and blood-thinning medications have been used effectively in certain situations.

The surgical management of avascular necrosis can be divided into joint-preserving procedures and joint-replacement procedures.

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Treatment Options For Kienbocks Disease

Treatment depends on the stage and severity of the disease. Observation and immobilization may be sufficient in the early stages. For more advanced stages, surgery may be considered to reduce the load on the lunate bone by lengthening, shortening or fusing various bones in the forearm or wrist. Bone grafting or removal of the diseased lunate is sometimes performed. If the disease is very advanced, a compete wrist fusion may be necessary.

Hand therapy, while it does not change the course of the disease, can minimize the disability from the problem. Treatment is designed to relieve pain and restore function.

Dr. Patel will advise you of which treatment is most appropriate. Call 333-7888 to schedule your appointment with Atlanta Hand Specialist today.

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