Extreme proximal migration of dislocated lunate over carpal ligament – A case report

Abstract

Dislocation of the lunate and proximal pole of the scaphoid with displacement of the fragments proximal to the radiocarpal joint, characterized as a total dislocation, is very rare, with only six cases reported. Dislocated lunate are generally located around the radiocarpal joint or within carpal ligament. However, there have been no reports of dislocated lunate over the carpal ligament. We present a patient with volar dislocation of the lunate that featured extreme migration to approximately 6 cm proximal to flexor digitorum superficialis through the transcarpal ligament.

Traumatic volar dislocation of a hemi-scaphoid-lunate compound over the carpal ligament: Case report

“…The dorsal approach gives better exposure for anatomical alignment and interosseous ligament repair or reconstruction, and the volar approach enables direct repair of the palmar capsule, repair of ligament tears and carpal tunnel decompression [8] . In a case very similar to ours, reported by Lee et al [4] , the authors chose to use a single volar approach in order to decrease the risk of osteonecrosis. However, at twelve months follow up, despite having no evidence of osteonecrosis, the X-rays showed ulnar subluxation of scaphoid and dorsal-ulnar subluxation of lunate.…”

“…Palmar trans-scaphoid-lunate dislocation has rarely been reported in literature [2][3][4] . Our case featured a severely proximal dislocation of lunate and scaphoid complex.…”

“…Fracture-dislocations of the carpus represent a spectrum of complex injuries. Few cases of displacement of a dislocated lunate and a scaphoid fragment proximal to the radiocarpal joint have been reported [1][2][3][4] . The disruption of vascular structures and the extension of soft tissue lesion in this type of injuries puts the viability of the proximal pole of the scaphoid and lunate at high risk [5] .…”