Gallego Peñalver F J, Romero de la Higuera S B, Pueyo Ruiz C M, Prados Lumbierres A M
Servicio de Medicina Física y Rehabilitación, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Servicio de Medicina Física y Rehabilitación, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Rehabilitacion (Madr). 2021 Oct-Dec;55(4):316-319. doi: 10.1016/j.rh.2020.08.001. Epub 2020 Dec 1.
Semilunar osteonecrosis or Kienböck's disease has a low prevalence, usually occurring in young men aged between 20 and 40 years. This disease is even less common in childhood. The aetiology varies, with postulation of the vascular trauma theory and the non-traumatic theory, in which the disease is caused by various other mechanisms. Semilunar involvement can occur with bone oedema, fragmentation, and scapholunate misalignment and progresses towards collapse. We present the case of an adolescent boy with Kienböck's disease, with no attributable traumatic antecedent, who developed a complex classification injury on the Litchman scale. Partial improvement of symptoms was achieved with conservative treatment but without definitive pain elimination. Future surgery for this patient is currently being discussed, bearing in mind his skeletal maturity and the pathophysiological progression of the injury.
月骨缺血性坏死或肯博克氏病发病率较低,通常发生在20至40岁的年轻男性中。这种疾病在儿童时期更为罕见。病因各不相同,有血管创伤理论和非创伤理论的假设,其中疾病由各种其他机制引起。月骨受累可伴有骨水肿、碎裂和舟月关节错位,并逐渐发展为塌陷。我们报告了一例患有肯博克氏病的青少年男孩病例,无明显创伤史,其损伤根据利奇曼量表属于复杂分类。保守治疗使症状部分改善,但未能完全消除疼痛。考虑到患者的骨骼成熟度和损伤的病理生理进展,目前正在讨论其未来的手术治疗方案。