Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive dorsal wrist pain localized to the lunate fossa. Reports exacerbation with loading or repetitive wrist motion. Denies acute trauma. Notes associated stiffness, decreased grip strength, and occasional nocturnal aching. Symptoms are consistent with stage [Insert Lichtman Stage] Kienbockโs disease.
Clinical Examination Findings
Physical exam reveals localized tenderness over the lunate (distal to Lister's tubercle). Range of motion is limited in both flexion and extension. Grip strength is reduced compared to the contralateral side. No signs of distal neurovascular compromise. Scapholunate interval stability assessed.
Treatment Protocol
Treatment plan initiated: Activity modification, splinting/immobilization for symptom relief, and NSAIDs. Discussion regarding surgical intervention (e.g., radial shortening osteotomy, revascularization, or proximal row carpectomy) based on Lichtman staging and ulnar variance.