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We present the case of a 30\u2010year\u2010old patient with Down syndrome who came to our observation for treatment of stage III C Kienb\u00f6ck disease. In September 2019, the patient reported wrist pain with limitation in movements and initially underwent conservative treatment without benefit. In October 2020, pain symptoms and difficult movements with reduced strength worsened and surgical treatment was proposed, but the patient and his family declined. Thereby the patient underwent conservative treatment with hyperbaric oxygen therapy (HBOT) 60 sessions, 100% oxygen at 2.5 absolute atmospheres (ATA), oxygen total time 60\u2009min, once daily, five times per week. After 6 months, a positive clinical and radiological evolution were observed, with an improvement in the patterns of pain, motion, and strength and an almost complete involution of the process of aseptic necrosis of the semilunar. To the best of our knowledge, this is the first report of stage III C Kienb\u00f6ck's disease in Down's syndrome patient treated with HBOT.<\/jats:p>","DOI":"10.1002\/ccr3.6524","type":"journal-article","created":{"date-parts":[[2022,11,19]],"date-time":"2022-11-19T23:42:22Z","timestamp":1668901342000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hyperbaric oxygen therapy in stage III C Kienb\u00f6ck disease: Time is bone"],"prefix":"10.1002","volume":"10","author":[{"given":"Andrea N.","family":"Cracchiolo","sequence":"first","affiliation":[{"name":"UOC Emergenza Urgenza 118 e servizio di Medicina Iperbarica ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Genco","sequence":"additional","affiliation":[{"name":"UOC Emergenza Urgenza 118 e servizio di Medicina Iperbarica ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalia","family":"Lo Bue","sequence":"additional","affiliation":[{"name":"UOC Emergenza Urgenza 118 e servizio di Medicina Iperbarica ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Palmeri","sequence":"additional","affiliation":[{"name":"UOC Emergenza Urgenza 118 e servizio di Medicina Iperbarica ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Tantillo","sequence":"additional","affiliation":[{"name":"UOC Emergenza Urgenza 118 e servizio di Medicina Iperbarica ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Re","sequence":"additional","affiliation":[{"name":"UOC Emergenza Urgenza 118 e servizio di Medicina Iperbarica ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biagio","family":"Bonanno","sequence":"additional","affiliation":[{"name":"UOC Emergenza Urgenza 118 e servizio di Medicina Iperbarica ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Finazzo","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Maria","family":"Palma","sequence":"additional","affiliation":[{"name":"UOC Emergenza Urgenza 118 e servizio di Medicina Iperbarica ARNAS Civico Di Cristina Benfratelli  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2005.08.002"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193410373703"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0712(21)01262-2"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00421"},{"key":"e_1_2_10_6_1","unstructured":"Ossigenoterapia iperbarica (OTI) durante il periodo di emergenza per COVID\u201019.Documento di posizionamento SIAARTI SIMSI ANCIP AS.PA.T.I. 22 Marzo 2020.https:\/\/simsi.it"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.11606"},{"key":"e_1_2_10_8_1","unstructured":"Antu\u00f1a ZapicoJM.Malacia del semilunar. 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