The etiology of Kienbock’s disease is controversial and not yet universally agreed upon. Similarly, there is no agreed upon method of treatment for Kienbock’s disease. An association between lunate vascularity, ulnar variance (the relationship between the distal radius and distal ulna length), and development of the disease has been noted. The association between ulnar variance and Kienbock’s disease is the basis of the currently popular treatment options: joint leveling, lunate revascularization, partial intercarpal arthrodesis, and carpal excisions. Clinical studies have shown that, when performed according to accepted indications and disease stage, each procedure shares similar success. Unfortunately, these studies are based almost entirely on data drawn from adult patient populations. To date it remains unclear whether pediatric and adolescent Kienbock’s disease stems from a particular etiology, and whether this patient population will respond similarly to the adult population.

Kienbock’s disease in young people is a rare entity. The reported incidence is less than 1.5% for patients less than 16 years of age. Several case reports have supported immobilization as the preferred treatment for Kienbock’s disease in young people. With the exception of a small number of studies, this conservative method of treatment has not been successful in the adult patient population. It is now common to treat Kienbock’s disease surgically in adults. The purpose of our study is to address whether the young patient with Kienbock’s would respond more favorably to non-operative care, immobilization, than the adult population. Due to its rarity, our series of eight pediatric and adolescent patients with Kienbock’s disease is the largest group yet compiled.