Kang Gun Woo, Lee Da Young, Lee Young-Hwan, Ahn Ki Sung, Kim Shin-Kun, Lee In Hee
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
Hemodial Int. 2013 Oct;17(4):648-51. doi: 10.1111/hdi.12048. Epub 2013 Apr 25.
Kienböck's disease, which consists of osteonecrosis and collapse of the lunate bone, causes chronic pain and dysfunction of the wrist. Patients on hemodialysis are occasionally present with wrist pain, but Kienböck's disease is rarely reported in dialysis patients. This case study describes Kienböck's disease in a patient with end-stage renal disease on hemodialysis. A 39-year-old male with a 1-year history of hemodialysis presented with left wrist pain that increased progressively over 6 months. The patient had no history of trauma or any other risk factors known to be associated with Kienböck's disease. Physical examination of the wrist at the site of the arteriovenous fistula showed swelling and tenderness with decreased range of motion. Radiographic examination showed articular collapse and fracture of the body of lunate consistent with stage IIIb Kienböck's disease. An intercarpal arthrodesis with autogenous bone graft was performed.
月骨无菌性坏死病，包括月骨的骨坏死和塌陷，会导致腕部慢性疼痛和功能障碍。接受血液透析的患者偶尔会出现腕部疼痛，但透析患者中很少有月骨无菌性坏死病的报道。本病例研究描述了一名接受血液透析的终末期肾病患者的月骨无菌性坏死病。一名有1年血液透析病史的39岁男性，出现左手腕疼痛，在6个月内逐渐加重。该患者无创伤史或任何其他已知与月骨无菌性坏死病相关的危险因素。在动静脉瘘部位对腕部进行体格检查时，发现肿胀、压痛，活动范围减小。影像学检查显示月骨体关节塌陷和骨折，符合IIIb期月骨无菌性坏死病。进行了自体骨移植的腕间关节融合术。
