Year 2016 Vol. 24 No 2

CASE REPORTS

S.A. GOLOBORODKO1,2

BILATERAL KIENBOCKS DISEASE IN AN ELDERLY PATIENT

Kharkov Medical Academy of Postgraduate Education1,
Kharkov Regional Clinical Traumatological Hospital2, Ukraine

Kienböcks disease (avascular necrosis of the lunate carpal bone) occurs most often in men aged 18 to 40 years as for the patients older than 60 yrs it observes extremely rare (especially on both hands) and is described in a few works.
The article presents an extremely rare case of bilateral Kienbocks disease in the elderly patient. A patient of 63-yr-old complained of a sharp pain in the right wrist when moving and especially during physical activity, reduction of amplitude of the active-passive movements in joint and working ability infringement. Pain and limitation of movement in the right wrist appeared for no reason 7 months ago. The condition gradually deteriorated. Conservative treatment wasnt carried out. After clinical and radiographic examination Kienbocks disease stage IIIB was diagnosed.
Proximal row carpectomy was performed. Treatment outcome was assessed 13 months after the surgery. The patient subjectively noted a significant pain relief during physical activity, improvement of limb function and disability. The amplitude of passive movements at the wrist joint was increased. During a follow-up the patient also said that pain without any reason had appeared in the left wrist 2 months ago. X-ray was performed and Kienböcks disease stage IIIB of the left wrist was found out. The man refused any treatment. Three years after the operation during a telephone survey a patient reported that the state of the operated limb has not worsened.

Keywords: wrist disease, lunate bone, bilateral Kienböcks disease, avascular necrosis, carpectomy, physical activity, elderly patient
p. 193-196 of the original issue
References
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  2. Taniguchi Y, Yoshida M, Iwasaki H, Otakara H, Iwata S. Kienböck's disease in elderly patients. J Hand Surg Am. 2003 Sep;28(5):779-83.
  3. Thomas AA, Rodriguez E, Segalman K. Kienböck's disease in an elderly patient treated with proximal row carpectomy. J Hand Surg Am. 2004 Jul;29(4):685-88.
  4. Lichtman DM, Lesley NE, Simmons SP. The classification and treatment of Kienbock's disease: the state of the art and a look at the future. J Hand Surg Eur. 2010 Sep;35(7):549-54. doi: 10.1177/1753193410374690.
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  6. Geissler WB, Slade JF. Fractures of the carpal bones. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, eds. Greens operative hand surgery. 6th ed. Philadelphia, US: Churchill Livingstone; 2011. . 639-707.
Address for correspondence:
61178, Ukraine
Harkov, Saltovskoe shosse d. 266, k. V,
Harkovskaya oblastnaya klinicheskaya
travmatologicheskaya bolnitsa, kafedra kombustiologii,
rekonstruktivnoy i plasticheskoy khirurgii,
e-mail: golosa@ukr.net,
Goloborodko Sergey Anatolevich
Information about the authors:
Goloborodko S.A. PhD, an associate professor of combustiology, reconstructive and plastic surgery chair of Kharkov Medical Academy of Postgraduate Education.
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