Avascular osteonecrosis of the scaphoid (Preiser’s disease) in a 13-year-old boy treated with vascularized bone graft

Barthel, Pierre-Yves; Blum, Alain; Dautel, G.

doi:10.1177/1753193411428995

Cited by 2 publications

(4 citation statements)

References 4 publications

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“…The treatment for Preiser disease in children is unclear. We found four cases of Preiser disease in children [ 18 – 21 ]. One patient treated with a vascularised bone graft showed improvement in both clinically and radiologically [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Preiser disease in a child before complete ossification of the scaphoid: a case report

Fujibuchi

Imai

Jono

et al. 2022

BMC Musculoskelet Disord

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Background The pathology of Preiser disease remains controversial, and treatment for Preiser disease has not yet been standardised. Preiser disease itself is rare, and although it can be found in children, its presentation is even rarer; therefore, the treatment of paediatric patients with Preiser disease is more unclear than adult cases. Case presentation A 10-year-old boy who complained of left wrist pain was diagnosed with Preiser disease from osteosclerosis and segmentation on plain radiography and computed tomography, and low signal intensity on both T1- and T2-weighted images on magnetic resonance imaging. Because the patient was a child whose scaphoid was immature and pre-ossified, we chose a conservative immobilisation treatment with a thumb spica cast followed by an orthosis. After 3 months of immobilisation, the distal pole of the scaphoid showed remodelling. One year after the initial visit, plain radiography showed remodelling of the whole scaphoid, although magnetic resonance T1-weighted image showed that the recovery of intensity change was only observed in the distal pole. Two years after the initial visit, both plain radiography and magnetic resonance imaging showed a normal appearance and 5 years after the initial visit; the scaphoid bone showed normal development. Conclusions This is the first case report of Preiser disease before complete ossification of the scaphoid; therefore, we cannot say anything definitive about the treatment strategy. However, our experience suggests that conservative treatment may provide a cure for Preiser disease in children with immature ossification of the scaphoid without carpal collapse.

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Section: Discussionmentioning

confidence: 99%

“…We found four cases of Preiser disease in children [ 18 – 21 ]. One patient treated with a vascularised bone graft showed improvement in both clinically and radiologically [ 21 ]. Two patients treated with immobilisation showed a good clinical course [ 18 , 20 ], and the last patient had no mention of the treatment [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Preiser disease in a child before complete ossification of the scaphoid: a case report

Fujibuchi

Imai

Jono

et al. 2022

BMC Musculoskelet Disord

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“…Waters and Stewart achieved union and good function with vascularized bone grafting and internal fixation after failure of immobilization [ 3 ]. Barthel et al reported one case of AVN treated with vascularized bone grafting and internal fixation, obtaining union and pain relief [ 1 ]. The initial diagnosis and management in these studies were based on signal loss of the scaphoid on MRI T1 [ 2 – 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cases of avascular necrosis (AVN) of the scaphoid are very rare with only six cases regarding the management of AVN in children reported [ 1 – 3 ]. Because of the limited reports there is currently no consensus when conservative or operative treatment is indicated.…”

Section: Introductionmentioning

confidence: 99%

The Role of Dynamic Contrast-Enhanced MRI in a Child with Sport-Induced Avascular Necrosis of the Scaphoid: A Case Report and Literature Review

Koc

Schotanus

Jong

et al. 2016

Case Reports in Orthopedics

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Avascular necrosis (AVN) of the scaphoid in children is very rare and there is currently no consensus when conservative or operative treatment is indicated. A 10-year-old boy, practicing karate, presented with acute pain in his left wrist after falling on the outstretched hand. Imaging showed a scaphoid waist fracture with signs of an ongoing AVN. The diagnosis of AVN was confirmed with signal loss of the scaphoid on MRI T1. A dynamic contrast-enhanced MRI was performed for further assessment of the proximal pole vascularity and treatment planning. As dynamic contrast-enhanced MRI showed fair perfusion of the proximal pole, an adequate healing potential with conservative treatment was estimated. We achieved union and good function with cast immobilization for fourteen weeks. This case study showed dynamic contrast-enhanced MRI to be a valuable tool in assessing whether conservative or operative treatment is indicated to achieve union and good functional outcome.

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Avascular osteonecrosis of the scaphoid (Preiser’s disease) in a 13-year-old boy treated with vascularized bone graft

Cited by 2 publications

References 4 publications

Preiser disease in a child before complete ossification of the scaphoid: a case report

Preiser disease in a child before complete ossification of the scaphoid: a case report

The Role of Dynamic Contrast-Enhanced MRI in a Child with Sport-Induced Avascular Necrosis of the Scaphoid: A Case Report and Literature Review

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