[Preiser's disease: a five-case series]

Abstract

Preiser's disease, or avascular necrosis of the scaphoid occurs without fracture or non-union. Between 1998 and 2009, the authors report on 5 patients who complained of mild pain on the radial aspect of the wrist, associated with stiffness and/or loss of strength. Our management consisted in different options: one bilateral intraarticular injection of hyaluronic acid, three vascularised radial bone graft and one resection of the first carpal row. With four and a half years follow-up, our results are quite satisfactory for improvement of pain, sometimes with residual postoperative stiffness. Management remains difficult because Preiser's disease is rare and there are no relevant prospective control studies. We attempt to provide an algorithm for early management of the disease and to answer the question: "until when can we save the scaphoid and how?"