Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 18143
  Title Postsurgical rehabilitative management of avascular necrosis in the capitate [case report]
Journal J Manipulative Physiol Ther. 2004 Oct;27(8):519-524
Peer Review Yes
Publication Type Case Report
Abstract/Notes OBJECTIVE: To discuss a case of avascular necrosis of the capitate and the follow-up postsurgical rehabilitation.

CLINICAL FEATURES: A 41-year-old woman had severe left wrist pain. A short course of passive therapy was administered with no significant change. She was referred for additional diagnostic testing, including magnetic resonance imaging, which assisted in diagnosing the patient with avascular necrosis of the capitate. After undergoing surgical intervention, she was cleared to start an active rehabilitation program. She had significant loss of muscle strength and muscle atrophy and diminished active range of motion in the wrist and forearm.

INTERACTION AND OUTCOME: The patient underwent surgical intervention consisting of an arthroplasty to the capitate. The follow-up rehabilitation techniques included the use of active and passive stretching, therapeutic putty, and light dumbbells. The patient was seen a total of 21 times during a 9-week time period. Outcome assessments were given intermittently during care to monitor progress. At the end of the program, she reported full function of the wrist with minimal to no pain. A 6-month follow-up showed improvements that were maintained with little pain.

CONCLUSION: Avascular necrosis of the capitate is relatively rare. Advanced imaging should be used for diagnostic purposes. Surgical intervention may be warranted; however, it is recommended a postsurgical rehabilitative procedure be implemented.

Click on the above link for the PubMed record for this article; full text by subscription. The abstract is reproduced here with the permission of the publisher.

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