ABSTRACT
La osteonecrosis del semilunar o enfermedad de Kienböck es una entidad de baja prevalencia, más frecuente en varones jóvenes entre 20 y 40 años. Todavía más exclusiva en pacientes en edad infantil. De etiología variable, se baraja la teoría traumática vascular y la teoría no traumática causada por otros diversos mecanismos. La afectación del semilunar puede presentarse con edema óseo, fragmentación, desalineación escafo-lunar y progresar hacia el colapso. Presentamos el caso de un adolescente con enfermedad de Kienböck, sin antecedente traumático atribuible que desarrolló una lesión de compleja clasificación en la escala de Litchman. Se consiguió mejoría parcial de la clínica con tratamiento conservador, pero sin eliminar el dolor de forma definitiva. El planteamiento quirúrgico se debate actualmente teniendo en cuenta su madurez esquelética y evolución fisiopatológica de la lesión (AU)
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 (AU)
Subject(s)
Humans , Male , Child , Adolescent , Young Adult , Adult , Lunate Bone/diagnostic imaging , Lunate Bone/surgery , Osteonecrosis/etiology , Vascular System Injuries , Conservative TreatmentABSTRACT
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.
