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      Kienbock's Disease in a Child

      case-report

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          Abstract

          Kienbock's disease, which is an idiopathic osteonecrosis and collapse of the lunate bone, is an uncommon disease in children. This report describes a case of an 11-year-old girl, who presented with avascular necrosis of lunate bone confirmed by radiographic and magnetic resonance imaging evidence. After a short period of casting, the case was fully recovered within one year. The signal change was confirmed by magnetic resonance imaging, and the deformity of lunate that was demonstrated by avascular necrosis. The patient wore a long arm cast for six weeks, and after one year radiographic pattern was normalized.

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          Most cited references11

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          Radial shortening for the treatment of Kienböck's disease--a 5- to 10-year follow-up.

          E Almquist, J. Burns (1982)
          Kienböck's disease is probably caused by microfractures or stress fractures developing within the lunate. In about 32% of the population, the vascular pattern to the lunate is such that after fracture they are vulnerable to a secondary aseptic necrosis of the lunate. The high incidence of Kienböck's disease in patients with an ulnar minus variant wrist may be explained by an increased stress on the lunate in dorsiflexion and ulnar deviation. This study is a 5- to 10-year follow-up of patients with early stages of Kienböck's disease and ulnar minus variant treated by radial shortening procedures. Eleven of the 12 patients were satisfied with their treatment and showed functional improvement. These patients returned to their normal activities. Grip strength was satisfactory, and range of motion improved following surgery.
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            Aetiology of Kienböck's disease.

            Carlos Irisarri (2004)
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              Radiographic analysis of anatomical risk factors for Kienböck's disease.

              Filip Rega, Thomas Mulier, E Thienpont … (2004)
              The aim of this study was to identify possible anatomical risk factors for Kienbock's disease. We measured on a posteroanterior radiograph of the wrist, in zero-position, the Lunate Diameter and Height, Lunate Tilting Angle, Lunate Uncovering Index, Lunate Fossa Inclination, Radial Inclination and Ulnar Variance. We measured these seven parameters on the unaffected hand in the Kienböck group (N = 54) to avoid the influence of arthritic changes and on the dominant hand in a control group (N = 126). Statistical significant differences were found for a smaller Lunate Diameter and Height, a more radially inclined Lunate Tilting Angle and a flatter Radial Inclination (Student's t-test). This may result in more load transmission onto the lunate, which may lead to avascular necrosis.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Iran J Med Sci
                Journal ID (iso-abbrev): Iran J Med Sci
                Journal ID (publisher-id): IJMS
                Title: Iranian Journal of Medical Sciences
                Publisher: Shiraz University of Medical Sciences (Shiraz, Iran )
                ISSN (Print): 0253-0716
                ISSN (Electronic): 1735-3688
                Publication date (Print): June 2011
                Volume: 36
                Issue: 2
                Pages: 133-135
                Affiliations
                [1]Department of Orthopaedics, Imam Khomeini Hospital, Mazandaran, Iran.
                Author notes
                Correspondence: Masoud Shayesteh Azar MD, Department of Orthopaedics, Imam Khomeini Hospital, Po Box: 48166-33131, Mazandaran, Iran, Tel: +98 151 2260920, Fax: +98 151 2263754, Email: Mshayestehazar@yahoo.com
                Article
                Publisher ID: IJMS-36-133
                PMC ID: 3556749
                PubMed ID: 23358501
                SO-VID: 5a09992a-3d9d-499b-a0d9-5bccea79856d
                History
                Date received : 10 April 2010
                Date revision received : 24 August 2010
                Date accepted : 3 October 2010
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Medicine
                Keywords: lunate,avascular necrosis,kienbock's disease,osteonecrosis
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: lunate, avascular necrosis, kienbock's disease, osteonecrosis

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