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Case Reports
. 2024 Jun 28;16(6):e63352.
doi: 10.7759/cureus.63352. eCollection 2024 Jun.

Managing Kienbock Disease's Surgical Treatment and Outcome Analysis: A Case Report and Review of Literature

Ankit M Jaiswal  1 , Sandeep Shrivastava  1 , Yash Dhanwani  2 , Rohan Chandanwale  1 , Pallavi R Bhakaney  3
Affiliations
Case Reports

Managing Kienbock Disease's Surgical Treatment and Outcome Analysis: A Case Report and Review of Literature

Ankit M Jaiswal et al. Cureus. .

Abstract

A 38-year-old man without a severe traumatic history reported to the outpatient department (OPD) with wrist pain at the dorsal aspect, mild swelling, stiffness, and restricted mobility at the left wrist joint. The patient had been experiencing these symptoms for a year. There was sharp tenderness, graded as 4 above the lunate bone, on examination of the left wrist joint. Advanced imaging, which is magnetic resonance imaging (MRI), and radiographs suggested that the patient had Kienbock's illness. Typically, the surgical approach for Kienbock's used is wrist fusion or proximal row carpectomy. However, in this case, a novel strategy of bone grafting, scaphoid-capitate fusion, and lunate excision was adopted. This case report explains the outcome of our scaphoid-capitate arthrodesis, which was done to maintain functional mobility and relieve discomfort by halting the progression of carpal collapse and carpal-ulnar translation.

Keywords: kienbock’s disease; lichtman classification; orthopedic approach; recent approaches; scaphoid-capitate arthrodesis.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preoperative radiograph of the left wrist showing sclerosis and fragmentation of the lunate bone, rotation of the scaphoid bone, and minimal flattening of the lunate. (A) Anteroposterior view and (B) lateral view.
Figure 2
Figure 2. Preoperative MRI scan of the left wrist suggestive of sclerosis with marrow edema and collapse of the lunate bone with focal full-thickness chondral loss involving the articular surface of the distal radius and capitate suggestive of early secondary degenerative changes. (A) Anteroposterior view and (B) Lateral view.
MRI: magnetic resonance imaging.
Figure 3
Figure 3. Postoperative radiograph of lunate excision and scaphocapitate arthrodesis. (A) Anteroposterior view and (B) Lateral view.
Figure 4
Figure 4. Postoperative radiograph after one-year follow-up of lunate excision and scaphocapitate arthrodesis. (A) Anteroposterior view and (B) Lateral view.
See this image and copyright information in PMC

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