Article

Pain is the main problem in patients suffering from cerebral palsy, particularly in adults. The upper limbs are affected in 25% of cases. Here, we
report the case of a patient with Kienbock's disease.
METHOD: Clinical case and
literature review. A 28-year-old man suffering from dystonic quadriplegia
consulted for progressively worsening pain in the right wrist. Kienbock's disease
was diagnosed and conservative treatment with botulinum toxin in the flexor carpi
radialis recommended. A good result was obtained with a decrease in pain. This
result was still present two years later. DISCUSSION: Although few references are
made to it in literature, Kienbock's disease in cerebral palsy is probably
underestimated. Maintenance of the wrist in a permanent flexed position and
muscular hypertonia may be risk factors. Knowledge of this particular clinical
picture will enable it to be detected promptly and thus enable conservative
treatment to be organised with a maximum chance of therapeutic success,
preventing the need for surgery.
CI - 2009 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS ; FRANCAIS