Author(s): Figueira, PJ ; Alpuim Costa, D ; Barbagallo, N ; Guerreiro, F
Date: 2018
Persistent ID: http://hdl.handle.net/10400.17/3517
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): Adolescent; Diagnosis, Differential; Humans; Hyperbaric Oxygenation; Lunate Bone; Magnetic Resonance Imaging; Male; Osteonecrosis; Gymnastics; HCC ORT
Kienböck's disease is a rare condition characterised by avascular necrosis of the lunate bone. Its natural history and aetiopathogenesis have not yet been clarified, nor are its triggering factors identified. We present a case of a 17-year-old male gymnast, without relevant medical/family history, with stage IIIA Kienböck's disease diagnosed in 2016. Initially, submitted to conservative treatment that proved to be insufficient. Consequently, surgical treatment was proposed, but refused. The patient instead underwent experimental treatment with hyperbaric oxygen (120 sessions, 100% oxygen at 2.5 atm, for 70 min periods, once daily, five times per week). In April 2018, a favourable clinical and radiological evolution was observed, with an improvement in the patterns of pain, motion and strength and an almost complete involution of the process of aseptic necrosis of the semilunar. To the best of our knowledge, this is the first report of Kienböck's disease treated with hyperbaric oxygen.
