Wrist Disorders
A 28-year-old male manual laborer presents with progressive right wrist pain over 18 months. The pain is worse with gripping and lifting. Examination reveals tenderness over the dorsal wrist centered on the lunate and reduced grip strength. X-rays show a sclerotic lunate with early fragmentation. The ulna appears shorter than the radius. MRI shows complete loss of signal in the lunate on T1-weighted images. Regarding Kienböck disease:
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Kienböck disease is avascular necrosis of the lunate; risk factors include ulnar negative variance, ...
The Lichtman classification stages disease progression: Stage I (normal X-ray, MRI changes only), St...
Kienböck disease primarily affects elderly patients over 60 years; ulnar positive variance is the ma...
Treatment in early stages (I-II) includes immobilization, activity modification, and unloading proce...
Advanced disease (Stage IIIB-IV) with carpal collapse requires salvage procedures; options include p...
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