Intraosseous pressure measurement in Kienboeck's disease--initial findings

Abstract

Intraosseous pressure was measured under standardized and different functional conditions in 11 necrotic lunates in different stages of the disease and in 11 viable lunates. Both the viable and the necrotic lunates show a significant increase of the pressure, if the wrist is brought into dorsiflexion. Both groups do not differ significantly, but the mean value of the necrotic group exceeds that of the viable group clearly. There might have some technical problems in measuring. Venous stasis by tourniquet provoked increase of pressure, too. The increase of pressure both in dorsiflexion and in venous stasis is evidence of venous drainage. Dorsiflexion impairs the venous drainage of the lunate, which promotes necrosis. The increase of intraosseous pressure in necrotic lunates can be understood as a failure of the physiologic regulation of the intraosseous pressure by moving the wrist and cause of necrotic changes.