Kienböck's Disease in a Patient With Cerebral Palsy: Case Report and Literature Review

Kienböck's disease is a rare condition characterized by avascular necrosis of the lunate bone, with a multifactorial etiology that remains not fully understood. Since its first reported association with cerebral palsy (CP), several factors have been suggested to contribute to its higher prevalence in this population. We present the case of a 17-year-old adolescent with CP and spastic-dyskinetic tetraparesis who developed left wrist pain without any history of trauma. Initial radiographs raised suspicion of lunate mild sclerosis, and magnetic resonance imaging confirmed the diagnosis of Kienböck's disease. The patient was treated with botulinum toxin injections, resulting in pain relief and functional improvement. A review of the literature supports the observation that Kienböck's disease may be more prevalent in individuals with CP than in the general population, although it is likely underdiagnosed. Conservative management, including the use of botulinum toxin A (BoNT-A), may be effective in controlling pain and preserving function. Early recognition of Kienböck's disease in this population is essential for appropriate and individualized management, taking into account each individual's functional and cognitive profile.