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J Hand Microsurg 2020; 12(S 01): S58-S60
DOI: 10.1055/s-0039-1681114
Case Report

Avascular Necrosis with Cystic Changes in the Triquetrum after Trauma in Combination with Heavy Smoking and Local Corticosteroid Injections

Zachri Nathan Ovadja
1   Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
2   Department of Plastic, Reconstructive and Hand Surgery, OLVG, Amsterdam, The Netherlands
,
Clinton Youri Snel
2   Department of Plastic, Reconstructive and Hand Surgery, OLVG, Amsterdam, The Netherlands
,
Oren Lapid
1   Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
,
Jesse Van Lieshout
2   Department of Plastic, Reconstructive and Hand Surgery, OLVG, Amsterdam, The Netherlands
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Abstract

The triquetrum is rarely affected by avascular necrosis compared with other carpal bones. We report a case of avascular necrosis of the triquetrum in a 50-year-old patient, with a history of wrist trauma, local corticosteroid injections, and heavy smoking. She presented with severe wrist pain and signs of cystic changes and avascular necrosis determined by magnetic resonance imaging. She was effectively treated with a proximal row carpectomy. We suspect that the combination of the injury in combination with local corticosteroids and smoking may have led to the necrosis.

Keywords

avascular necrosis of bone - carpal bones - osteonecrosis - triquetrum - wrist injuries


Publication History

Article published online:
25 February 2019

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  • References

  • 1 Por YC, Chew WY, Tsou IY. Avascular necrosis of the triquetrum: a case report. Hand Surg 2005; 10 (01) 91-94
    CrossrefPubMedGoogle Scholar
  • 2 Lafforgue P. Pathophysiology and natural history of avascular necrosis of bone. Joint Bone Spine 2006; 73 (05) 500-507
    CrossrefPubMedGoogle Scholar
  • 3 Assouline-Dayan Y, Chang C, Greenspan A, Shoenfeld Y, Gershwin ME. Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum 2002; 32 (02) 94-124
    CrossrefPubMedGoogle Scholar
  • 4 Albtoush OM, Esmadi M, Al-Omari MH. Cystic avascular necrosis of the triquetrum. Clin Imaging 2013; 37 (02) 393-397
    CrossrefPubMedGoogle Scholar
  • 5 Amsallem L, Serane J, Zbili D, Marion B, Boyer P. Idiopathic bilateral lunate and triquetrum avascular necrosis: a case report. Hand Surg Rehabil 2016; 35 (05) 367-370
    CrossrefPubMedGoogle Scholar
  • 6 Gelberman RH, Panagis JS, Taleisnik J, Baumgaertner M. The arterial anatomy of the human carpus. Part I: the extraosseous vascularity. J Hand Surg Am 1983; 8 (04) 367-375
    CrossrefPubMedGoogle Scholar
  • 7 Gelberman RH, Gross MS. The vascularity of the wrist. Identification of arterial patterns at risk. Clin Orthop Relat Res 1986; (202) 40-49
    PubMedGoogle Scholar
  • 8 Wen Z, Lin Z, Yan W, Zhang J. Influence of cigarette smoking on osteonecrosis of the femoral head (ONFH): a systematic review and meta-analysis. Hip Int 2017; 27 (05) 425-435
    CrossrefPubMedGoogle Scholar
  • 9 Lutsky K, Beredjiklian PK. Kienböck disease. J Hand Surg Am 2012; 37 (09) 1942-1952
    CrossrefPubMedGoogle Scholar