29 / 2017-07-04 19:57:01

Avascular necrosis of the carpal scaphoid (Preiser's disease): a case report and review of the literature

Avascular necrosis ,carpal scaphoid,Preiser's disease,four-corner arthrodesis,wrist

Avascular necrosis of the carpal scaphoid has been rarely reported. In our case, a 60-year-old women was seen initially with pain in the left wrist of five-years’ duration. Pain and swelling had increased with prolonged use of the hand several months before she was seen. No history of trauma could be elicited. Examination of her left hand and wrist revealed decreased range of motion of the wrist secondary to pain, without thenar atrophy and decreased sensitivity in the radial three digits, with a negative Phalen’s sign and a negative Tinel’s sign. Routine x-ray films of the left hand and wrist revealed the fragmentation and pathologic fracture in proximal pole of the scaphoid, but without marked radio-scaphoid changes. However, wrist pain has continued despite conservative measures. Finally, the necrotic scaphoid were removed and four-corner arthrodesis was performed with three hollow screw. the necrotic scaphoid was confirmed by histopathological examination.