Abstract
Background Kienbock's disease is primarily seen in young adult males but has been recognized
in skeletally immature populations as well. Traditional treatment strategies recommend
operative treatment but high remodeling potential in children may allow conservative
management.
Case Description We present the case of a 7-year-old female with 2 months of atraumatic right wrist
pain who was found to have edematous signal change within the lunate on wrist magnetic
resonance imaging (MRI) consistent with Kienbock's disease. She was treated with rigid
immobilization for 12 weeks and transitioned to custom orthotic splint for another
3 months during activities. At her 6 month follow-up, she reported minimal wrist pain
with repeat MRI demonstrating the resolution of lunate edema.
Literature Review Available literature shows a significant portion of patients treated conservatively
subsequently require surgical intervention due to unresolved symptoms or progressive
disease. Only three cases are reported in the literature where skeletally immature
patients were successfully treated with conservative management alone
Clinical Relevance We report the youngest case of Lichtman stage I Kienbock's disease successfully treated
with conservative management resulting in clinical and imaging resolution. Younger
patients may be able to successfully remodel and recover from Kienbock disease with
extended time in conservative management.
Keywords
Kienbock disease - pediatric population - lunate - Lichtman staging - non-operative
management
