Treatment methods in idiopathic avascular necrosis of the scaphoid - review

Abstract

IntroductionIdiopathic avascular necrosis (AVN) of the scaphoid is commonly known as Preiser’s disease (PD). It is a rare condition with symptoms such as pain, swelling around the scaphoid area and a reduced range of motion of the wrist. This condition occurs in the absence of an acute fracture or a fracture non-union. The disease can be diagnosed using classic radiology, magnetic resonance imaging or computed tomography. Treatment methods include surgical nad non-surgical procedures.AimMain aim of the paper was to summarize most recent knowledge about treatment methods in idiopathic AVN of the scaphoid.Material and methodsTo conduct this review, we searched the databases for articles about PD. We used keywords ‘Preiser disease’ and ‘idiopthic avascular necrosis scaphoid’. Our focus was on articles published in between 2017 and 2023, as we wanted to focus on most recent publications.Results and discussionMain goals of the treatment of PD are pain relief, improved hand grip strength, wider range of motion of the wrist and enhanced overall hand and wrist function. Implementing conservative management seems not to bring satisfactory results in patients with PD. Various surgical routines are the treatment of choice.ConclusionsStage I of the disease is the most likely treated with bone-grafting or currettage. Method of choice in stage II is vascularized bone graft, in stage III – proximal row carpectomy. Due to the rarity of the disease, there are no established recommendations regarding the treatment. Further studies are needed to extend the knowledge of the disease and potential methods of its management.