Concomitant Avascular Necrosis of the Lunate and Proximal Pole of the Scaphoid in a Thalassemia Minor Patient

Abstract

Avascular necrosis (AVN) of multiple carpal bones is a very rare condition. This case report presents a patient with concomitant AVN of the lunate and proximal pole of the scaphoid that had led to severe joint space narrowing and degenerative arthritis in the radiocarpal and distal radioulnar joints (DRUJs). She was known to have thalassemia minor hemoglobinopathy. Wrist arthrodesis and distal ulna hemiresection-interposition arthroplasty (Bowers technique) for a DRUJ were offered and performed. The patient was satisfied with the clinical outcomes.

Coexisting Kienböck's and Preiser's Disease of the Wrist: Experience with Proximal Row Carpectomy with Dorsal Capsular Interposition Technique

“…Park et al reported a case with radio‐scaphoid and radio‐lunate fusion using a bent distal radius dorsal plate and autologous iliac bone graft. 11 Afshar et al treated a patient suffering from thalassemia minor hemoglobinopathy with total wrist fusion 12 (Table 1 ).…”

“…Treatment methods of Kienböck's disease and Preiser's disease are being established, but coexisting avascular necrosis of the scaphoid and lunate is too recently reported to standardize treatment. Coexisting Kienböck's and Preiser's diseases have been reported very rarely and has not been named; coexisting, concomitant, or combined Kienböck's and Preiser's diseases has been used in previous reports 8–12 . Staging and treatment of the disease have not been established, and associated studies treated patients based on arthritic changes of bones and on their theory of pathophysiology.…”

“…Coexisting Kienböck's and Preiser's diseases have been reported very rarely and has not been named; coexisting, concomitant, or combined Kienböck's and Preiser's diseases has been used in previous reports. 8 , 9 , 10 , 11 , 12 Staging and treatment of the disease have not been established, and associated studies treated patients based on arthritic changes of bones and on their theory of pathophysiology. We report a patient with coexisting avascular necrosis of the scaphoid and lunate without systemic disease or trauma.…”