PMC

A. Postoperative posteroanterior (A) and lateral (B) radiographs. The fragmented proximal scaphoid and whole lunate were resected.

Posteroanterior (A) and lateral (B) radiographs of right wrist taken 1 year, 4 months after initial surgery show no progression of osteoarthritis.

(A) Preoperative posteroanterior radiograph shows collapse of proximal pole of scaphoid bone without fragmentation (black arrow heads). (B) Preoperative lateral radiograph shows a scapholunate angle of 55° and a radiolunate angle of 20°.

Posteroanterior (A) and lateral (B) radiographs taken 7 years, 1 month after surgery show no progression of osteoarthritis of the wrist. The patient was satisfied with results and had no desire to pursue additional surgery.

(A) Preoperative posteroanterior T1-weighted MRI shows diffusely decreased signal intensity throughout the scaphoid and lunate bones (white arrow heads), compatible with Kalainov Type 1 Preiser disease. (B) Preoperative posteroanterior T2-weighted fast spin-echo MRI shows marked flattening of the scaphoid with extensive collapse of the subchondral trabecular bone and high intensity of the scaphoid (white arrow heads), compatible with bone edema.

A fragment of the scaphoid bone shows an area of necrosis involving the entire subchondral zone (black arrow heads) (A) represented by empty lacunae and necrotic debris in the intertrabecular space (black arrow heads) (B). At higher magnification, multilayering of a tide mark (C) and chondrocytic cloning (D) are noted, suggesting a regenerative reaction. All histological findings are characteristic of avascular necrosis of the scaphoid bone. Hematoxylin and eosin stain, ×12.5 (A), ×100 (B), and ×200 (C, D).