Maladie de Kienböck chez un garçon de neuf ans : à propos d’un cas

Kienböck's disease in an 11-year-old girl: a case report

Kienböck disease is a pathology that remains uncommon in children, therefore the number of published cases of Kienböck's disease before skeletal maturity is limited. The etiology of Kienböck's disease is still controversial. Although many therapeutic methods are described in the literature. There is no consensus treatment for this pathology. We describe a case of Kienböck's disease of an 11-year-old girl who presented with avascular necrosis of the lunate bone confirmed by the radiologic pattern. And who was treated with 10 weeks of splinting with satisfying clinical outcome. Wrist pain and other symptoms resolved after 2 months. A magnetic resonance imaging (MRI) confirmed partial revascularization of the lunate. After 18 months of follow-up the patient remains asymptomatic.

Infantile and juvenile lunatomalacia

Lunatomalacia or avascular necrosis of the lunate in children is a rare disease not described by Kienböck. It is somewhat surprising that the term Kienböck's disease has been used to describe this disease of the lunate in children. We report our experience in 13 cases and review the literature. In children under 12, the prognosis is very good after immobilization alone. Persistent symptoms may indicate surgery, probably radial shortening, in some older teenagers although the outcome appears better than in adults. We suggest the term lunatomalacia to describe this disorder, in recognition of the term originally used by Kienböck.