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Dong-Hee Kim, M.D.
, Yil-Ju Eho, M.D., Min Jeong, M.D.
, Yil-Ju Eho, M.D., Min Jeong, M.D.
Abstract
Kienbock's disease is very rare in pediatrics. The treatment of Kienbock's disease is controversial and depends on an understanding of the natural history of the disease. The methods proposed vary from conservative treatment to surgical treatment such as radial shortening or scaphotrapezoidal joint fixation, but there are few therapeutic guidelines for paediatric Kienbock's disease. We encountered a 14-year-old male with Lichtman stage IIIB disease and treated him with conservative management. We report this rare case of advanced paediatric Kienbock's disease with good clinical results at the 2-year follow-up along with a review of the relevant literature.
Figures and Tables
Figure 1
A 14-year-old male with wrist pain due to stage IIIA Kienbock's disease. Standard anteroposterior and lateral radiographs at presentation show that the lunate has sclerotic changes with a collapse of height. A neutral ulnar variance can be seen.
Figure 2
(A) Sagittal computed tomography image shows bony fragmentation of the lunate bone. (B) Coronal T1-weighted magnetic resonance imaging (MRI) shows diffuse hypointensity of the lunate bone. Coronal T2-weighted fat-suppressed MRI shows diffuse hyperintensity and collapse of the lunate bone.
Figure 3
Anteroposterior and lateral radiographs at 12 weeks after casting. The carpal height ratio did not change, and the collapse of the lunate did not progress.
References
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