Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive dorsal wrist pain, localized to the lunate region. Reports associated stiffness, decreased grip strength, and intermittent swelling. No history of acute trauma. Pain exacerbated by repetitive wrist motion and loading.
Clinical Examination Findings
Examination reveals tenderness over the lunate bone (distal to Lister's tubercle). Limited range of motion in flexion and extension. Grip strength reduced compared to the contralateral side. No signs of acute inflammation or neurovascular deficit. Positive lunatotriquetral ballottement test.
Treatment Protocol
Management plan includes immobilization with a wrist splint, NSAIDs for pain control, and activity modification. Surgical consultation for potential revascularization procedures (e.g., core decompression, radial shortening osteotomy) or proximal row carpectomy depending on Lichtman stage.