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Kienböck's disease and cerebral palsy case report
P Gallien1, G Candelier, B Nicolas
1Pôle MPR Saint-Hélier, Rennes, France. philippe.gallien@pole-sthelier.com
Annals of Physical and Rehabilitation Medicine
|December 8, 2009
Summary
Kienböck
Area of Science:
- Neurology
- Orthopedics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) frequently causes pain, especially in adults.
- Upper limb involvement occurs in 25% of CP cases.
- Kienböck's disease is a rare but significant cause of wrist pain in CP.
Observation:
- A 28-year-old male with dystonic quadriplegia presented with severe right wrist pain.
- Diagnosis of Kienböck's disease was confirmed.
- Conservative management involved botulinum toxin injections into the flexor carpi radialis.
Findings:
- Botulinum toxin treatment led to significant pain reduction.
- Pain relief was sustained for at least two years post-treatment.
- This indicates a positive response to conservative intervention.
Implications:
- Kienböck's disease in cerebral palsy patients may be underdiagnosed.
- Wrist flexion and hypertonia in CP could be risk factors.
- Early detection and conservative treatment can improve outcomes and avoid surgery.
