Kienböck's disease and cerebral palsy case report.
BACKGROUND
Pain is the main problem in patients suffering from cerebral palsy, particularly in adults. The upper limbs are affected in 25% of cases. Here, we report the case of a patient with Kienböck's disease.


METHODS
Clinical case and literature review. A 28-year-old man suffering from dystonic quadriplegia consulted for progressively worsening pain in the right wrist. Kienböck's disease was diagnosed and conservative treatment with botulinum toxin in the flexor carpi radialis recommended. A good result was obtained with a decrease in pain. This result was still present two years later.


CONCLUSIONS
Although few references are made to it in literature, Kienböck's disease in cerebral palsy is probably underestimated. Maintenance of the wrist in a permanent flexed position and muscular hypertonia may be risk factors. Knowledge of this particular clinical picture will enable it to be detected promptly and thus enable conservative treatment to be organised with a maximum chance of therapeutic success, preventing the need for surgery.
Gallien
P
P
Pôle MPR Saint-Hélier, Rennes, France. philippe.gallien@pole-sthelier.com
Candelier
G
G
Nicolas
B
B
Durufle
A
A
Petrilli
S
S
Robineau
S
S
Le Meur
C
C
Houedakor
J
J
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications*; D003131:Combined Modality Therapy; D006801:Humans; D007103:Immobilization; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D010146:Pain / Q000209:etiology*; D011782:Quadriplegia / Q000209:etiology; D011859:Radiography; D013165:Splints; D014457:Ulna / Q000473:pathology; D014953:Wrist
D000700:Analgesics; D019274:Botulinum Toxins, Type A