This 15 year old junior of the Dutch National water polo team fell from his bike about 18 months ago. No prior treatment has been installed.

This 15 year old junior of the Dutch National water polo team fell from his bike about 18 months ago. No prior treatment has been installed.


Dear all,

 

This 15 year old junior of the Dutch National water polo team fell from his bike about 18 months ago. No prior treatment has been installed.

Subsequent conventional X-rays revealed no abnormalities. A MRI showed a Kienbock, lunatomalacia grade I , according to Lichtman criteria and a volar lunate margin fracture. We started with  a cast immobilization for 8-12 weeks.

Can anyone comment on these questions?

 

- Natural history in adolescents ?

- anyone experience with bone growth stimulation in Kienbock s disease at this age?

- Fix the fracture?

- when would you advise him to go back to play or swim

- any alternative options?

 

Regards,

Reinier Feitz

Plastic surgeon

 

See attached .pdf file below

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