ePlasty: Vol. 17
Simultaneous Avascular Necrosis of the Lunate and Scaphoid
Benson J. Pulikkottil, MD, Edward Ruane, MD, Michael E. Scott, DO, Alexandre Philipp Sater, BS, and Joseph E. Imbriglia, MD

Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa

Correspondence: benpul@gmail.com
Keywords: avascular necrosis, lunate, scaphoid, Kienböck's disease, Preiser's disease
Figure 1. Preoperative posteroanterior radiographs showing progressive fragmentation and collapse of the lunate, as well as subsequent pathologic fracture of the scaphoid.
Figure 2. Intraoperative photograph showing the fragmented and avascular appearance of the scaphoid and lunate.
Figure 3. Postoperative posteroanterior radiograph showing satisfactory positioning of the capitate in the lunate facet.


Avascular necrosis (AVN) involving more than 1 carpal bone is a rare entity. In this case, a 60-year-old female smoker with simultaneous AVN of both the scaphoid and the lunate was treated with pr .......