Kienbock’s Disease with Volar Intercalated Segment Instability: A Therapeutic Dilemma

Abstract

The etiology of avascular necrosis of the lunate (Kienbock disease) remains unclear despite long clinical experience. Very rarely, it may be associated with carpal instability. We describe a case of 45-year-old female who had Kienbock disease with associated volar intercalated segment instability, detailing how the radiographic features can often cause a dilemma in the staging and management of this enigmatic problem.