II. Symptoms
- History of single major Wrist Injury
- History of multiple minor occupational injuries
- Chronic Wrist Pain, tenderness and swelling
- Restricted Wrist Range of Motion
- Dorsiflexion most often affected
III. Signs: Passive dorsiflexion aggravates pain
- Pain middle finger dorsiflexion
- Kienbock's disease (Lunate Avascular Necrosis)
- Pain on index finger dorsiflexion
- Preiser's Disease (Navicular Avascular Necrosis)
IV. Radiology: Wrist XRay
- Initially: Normal
- Eventually: Involved bone dense, white, and sclerotic
- Later: Bone fragmentation and collapse occur
- End Result: Degenerative Arthritis
V. Management
- Early stages
- Intermittent immobilization for months
- Allows reconstitution of normal bony architecture
- Cast removed on daily basis for ROM Exercises
- Later stages
- Surgery may be necessary