Proximal Row Carpectomy for Coexisting Kienböck’s Disease and Giant Intraosseous Ganglion of the Scaphoid: A Case Report and Review of the Literature

Abstract

The etiologies of Keinböck's disease and intraosseous ganglion remain unknown. Both entities are rare and the coexistence of these two pathologies in the same patient and hand is even less frequent. We report the case of a 40-year-old man with a longstanding history of martial arts practice (karate) who developed an avascular necrosis of the lunate concomitant with a giant intraosseous ganglion of the scaphoid bone successfully managed by proximal row carpectomy. We review the literature of these two diseases.

Flossing bands to treat keinböck’s disease in a collegiate men’s basketball player: a case report

“…Keinböck's disease (KD) is defined as ischemia and necrosis of the lunate bone that occurs in the absence of an acute fracture or nonunion fracture. 1 Presently, the exact etiology of KD is unknown, but is postulated to be secondary to repetitive or acute trauma to the wrist resulting in damage to the blood supply to the lunate. 2 In the absence of a definitive mechanism for KD, possible predispositions include; shape and size of the lunate, and vascularity of the lunate.…”

“…4 Standard conservative treatment of KD consists of immobilization of the joint then progressing to range of motion (ROM) and strengthening exercises of the surrounding musculature. 1,5 In the event that conservative treatment fails, surgical interventions may include; vascular grafting, radial shortening, ulnar lengthening, proximal row carpectomy, and decompression osteotomies. 1,5 Unfortunately, these present surgical options are often termed "salvage procedures".…”

“…1,5 In the event that conservative treatment fails, surgical interventions may include; vascular grafting, radial shortening, ulnar lengthening, proximal row carpectomy, and decompression osteotomies. 1,5 Unfortunately, these present surgical options are often termed "salvage procedures". 1 If a patient is forced to resort to surgery, the prognosis for returning to high level physical activity is poor.…”

“…1,5 Unfortunately, these present surgical options are often termed "salvage procedures". 1 If a patient is forced to resort to surgery, the prognosis for returning to high level physical activity is poor. 1 Tissue flossing is a relatively new treatment technique incorporating the use of latex bands to wrap the pathologic area prior to a brief bout of exercise.…”

“…1 If a patient is forced to resort to surgery, the prognosis for returning to high level physical activity is poor. 1 Tissue flossing is a relatively new treatment technique incorporating the use of latex bands to wrap the pathologic area prior to a brief bout of exercise. 6,7 Though available research is lacking, anecdotal evidence suggests that tissue flossing may be a viable method of increasing joint ROM, decreasing pain, and improving athletic performance.…”