A Case of a Combined Distal Radius and Lunate Fracture in Association with Kienböck's Disease.

The natural history of Kienböck's disease (KD) is often indolent until it progresses to an advanced stage causing pain and stiffness. Lunate fragmentation and collapse can sometimes occur with trauma. However, concomitant fracture of the distal radius is a rare phenomenon, and this combination can limit treatment options. The aim of this case report is to outline our management algorithm in the operative fixation of a young mechanic with known ipsilateral KD who was involved in a road traffic accident and suffered a combined distal radius and lunate fracture. He was managed with an open reduction internal fixation using a volar plate and a temporary dorsal spanning internal fixator. At a later date, the internal fixator was removed and a scaphocapitate fusion was performed to offload the lunate in order to avoid a total wrist fusion.