Year: 2026 | Month: July | Volume: 13 | Issue: 7 | Pages: 366-374
DOI: https://doi.org/10.52403/ijrr.20260738
Beyond Fixation: Structural Scaphoid Reconstruction for Preiser’s Disease with Humpback Collapse: A Case Report
Made Bramantya Karna1, Benedictus Anindita Satmoko1, Rafell Tantyo1
1Orthopaedic and Traumatology Department, Faculty of Medicine, Udayana University/Ngoerah General Hospital, Denpasar, Indonesia
Corresponding Author: Made Bramantya Karna
ABSTRACT
Preiser's disease, or idiopathic avascular necrosis of the scaphoid, is a rare condition that may cause progressive collapse, humpback deformity, carpal instability, and loss of wrist function in young adults, where joint-preserving reconstruction is increasingly emphasized. We report a 29-year-old man with chronic atraumatic left wrist pain for one year; imaging demonstrated idiopathic scaphoid avascular necrosis with humpback deformity and structural collapse, and preoperative VAS pain was 5 with grip strength 10.5 kg. He underwent volar open reduction with corrective osteotomy, reconstruction using a 1-cm structural corticocancellous iliac crest autograft to restore scaphoid height and alignment, and fixation with a 2.4-mm headless compression screw. At 3-month follow-up, pain decreased from VAS 5 to 1, grip strength improved from 10.5 kg to 30 kg, and the patient returned to work. Wrist motion improved in flexion, extension, pronation, and supination, and radiographs showed maintained deformity correction and restored carpal alignment. Structural iliac crest autograft provides biological and mechanical support, while headless compression screw fixation enables stable compression. This technique represents a promising joint-preserving reconstructive option for selected young patients with scaphoid collapse and carpal instability.
Keywords: Preiser's disease; scaphoid avascular necrosis; humpback deformity; iliac crest autograft; headless compression screw; wrist reconstruction
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