Rehabilitation After Distal Radial Osteotomy for Kienböck’s Disease: A Case Report on the Integration of Mirror Therapy in Postoperative Management

BACKGROUND: Kienböck's disease, avascular necrosis of the lunate, often requires surgical treatment such as distal radial osteotomy, yet postoperative rehabilitation literature is sparse. This case report describes mirror therapy integrated with conventional rehabilitation after a distal radial osteotomy to reduce pain, improve grip strength, and restore wrist function.

CASE DESCRIPTION: A 51-year-old man presented one month after distal radial osteotomy for Stage III Kienböck's disease with persistent left wrist pain (NPRS 7/10), severely reduced grip strength (2 kg), and functional disability (QuickDASH 45). He completed a four-week rehabilitation program that included mirror therapy, low-intensity pulsed ultrasound, myofascial release, progressive resistance training, and scar mobilization.

OUTCOMES: After four weeks, the NPRS decreased to 2/10, QuickDASH improved to 10, and grip strength increased from 2 kg to 20 kg. Wrist flexion improved from 55° to 70°, extension from 45° to 60°, and the MMT grade improved from 3 to 4.

CONCLUSION: A multimodal rehabilitation program incorporating mirror therapy was associated with clinically meaningful improvements in pain, ROM, strength, and function, supporting further investigation of mirror therapy as an adjunct after distal radial osteotomy.