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Rehabilitation of an athelete with Kienbock’s disease


Kienböck’s disease, a vascular necrosis of the lunate, has remained controversial in its basic etiology, natural history and therefore treatment.


This case report describes the hand therapy process of improving the range and strength of a 17-year-old female gymnast to return her to competitive gymnastic training and the competition arena.


17-year-old female gymnast, left hand dominant, started hand therapy 8 weeks after a vascularised medial femoral trochlea osteochrondral flap reconstruction to her right wrist.

Initial status, 8 weeks post-operation: AROM fingers full; AROM wrist extension 20°; AROM wrist flexion 15°; AROM wrist radial deviation 8°; AROM wrist ulnar deviation 8°; AROM pronation 70°; AROM supination 90°; QuickDASH disability / symptom score 47.7; QuickDASH sports module score 100. Patient underwent bi-weekly therapy sessions for first 4 weeks focusing on dart-throwers motion, A/PROM, therapeutic exercise and modalities. This is followed by weekly sessions focusing on strengthening and simulation of gymnastic training.


16 weeks post-operation: AROM fingers full; AROM / PROM wrist extension 45° / 50°; AROM / PROM wrist flexion 35° / 50°; AROM wrist radial deviation 15°; AROM wrist ulnar deviation 25°; AROM pronation 80°; AROM supination 90°; right grip / left grip strength 13.3kg / 21.7kg; QuickDASH disability / symptom score 6.8; QuickDASH sports module score 50.


During the process of rehabilitation, while range of motion and strength remains the tenet of hand therapy, emphasis was also placed on unloading and maintaining the blood supply to the wrist, specifically to the lunate.

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Correspondence to Janis Yeo Siew Ting.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Ting, J.Y.S. Rehabilitation of an athelete with Kienbock’s disease. BMC Proc 9, A106 (2015).

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  • Natural History
  • Blood Supply
  • Symptom Score
  • Grip Strength
  • Therapy Session