1 Koji Shigematsu treated an 11-year-old girl with Kienbock disease (stage IIIA) by temporary scaphotrapeziotrapezoidal pin fixation. The pins were removed after eight weeks. In follow up, movement of the wrist and grip strength improved, and pain disappeared. Revasculariztion of lunate was demonstrated on MRI.9 In another report by Ferlic, a 13-year-old boy with symptomatic stage III Kienböck’s disease was treated successfully with a radial see more shortening procedure. This case showed evidence of Inhibitors,research,lifescience,medical lunate revascularization and remodeling after a radial shortening osteotomy.10 In the study of Almquist, twelve patients with early stages of Kienbock’s disease and ulnar minus variant were treated by radial shortening
procedures, and were followed for five to ten years. Eleven of
the cases showed functional improvement. Inhibitors,research,lifescience,medical Grip strength and range of motion improved following surgery.11 Luc De Smet,5 reported a case of a twelve-year-old girl with grip, which is similar to the present case. The case was treated conservatively, and during one year follow up favorable outcome was achieved, and the patient was pain free. The goal of surgical procedures is to unload the lunate and to decrease the compressive forces. These will result in the prevention of additional fragmentation and collapse, and theoretically improve revascularization Inhibitors,research,lifescience,medical of the lunate. Joint leveling is probably the most commonly used technique.1,4 The case in the present study wore a long arm cast for six weeks, and was forbidden from all her sporting activities. Clinically, wrist pain and other symptoms resolved, Inhibitors,research,lifescience,medical and after one year, radiographic pattern was normalized (figure 4). kienbock’s disease rarely occurs in children, however, early diagnosis can result in simple nonoperative treatment, which is usually associated with a good outcome. Because of the disease’s progressive and destructive
Inhibitors,research,lifescience,medical effects on the wrist, it is important for physicians to take the announcement of the condition, try to diagnose it, and refer the patients to expert authorities in the early stages. Conflict of Interest: None declared
Metastasis from breast cancer to other parts of the body is very common, but the spread of the tumor to pituitary gland, especially to infandibulum, is a rare presentation. At the time of pituitary metastasis, secondly a majority of the patients have clinical and radiological evidence of the disease. It seems that the posterior area of the gland is the most common site of metastasis, probably due to highly rich blood supply through the hypophyseal artery. The present report introduces a case of a 55-years-old woman presented with diabetes insipidus resulting from metastasis of the tumor to pituitary infandibulum, which is a rare site for metastasis, without significant complaint resulting from metastasis to other part of the body, or other primary diseases.