Inter-Carpal Dislocations and Fracture-Dislocations

Abstract

1. Fifty-nine patients with various inter-carpal dislocations have been reviewed. 2. In this series trans-scapho-perilunar fracture-dislocation was the commonest injury. Early cases can be reduced by closed manipulation but in late cases operative reduction is usually advisable. When the injury is more than three months old, arthrodesis of the wrist joint is indicated. 3. When trans-scapho-perilunar fracture-dislocation was complicated by avascular necrosis of the proximal scaphoid fragment, the results in a small series treated by early excision were approximately equal to those treated by continued immobilisation. The results of grafting the scaphoid were poor. 4. Dislocations of the lunate seen within ten days of injury could usually be reduced with good results; no such case developed Kienböck's disease within the period of review. In late cases excision gave satisfactory results. 5. Forward dislocation of the lunate with half the scaphoid gave good results when manual reduction succeeded, but the results of excision of fragments were less satisfactory. 6. There was one case of forward dislocation of the lunate together with the distal half of the scaphoid. 7. Subluxation of the scaphoid is disclose in antero-posterior radiographs by a typical gap between it and the lunate bone. The subluxation may become recurrent and present a characteristic syndrome. 8. Other rare dislocations of the carpal bones are described.

Combined Dislocation of the Trapezium and the Trapezoid: A Case Report with Review of the Literature

“…Chronic cases of trapezoid dislocations have been treated without reduction [6,41]. Salvage procedures include excision of the trapezium or trapezoid, as well as limited arthrodesis [3,15,16,18,19,22,23,31,35,42,47,51].…”

Trans-Scaphoid Perilunate Fracture Dislocations: Results of Screw Fixation of the Scaphoid and Lunotriquetral Repair With a Dorsal Approach

“…Abnormal carpal mechanics can decrease function and lead to arthritis. Treatment recommendations have changed greatly over the years from closed reduction and casting, 16 lunate excision, 17 proximal row carpectomy, 18 Four-corner fusion, 19 external fixation with or without internal fixation, 19 and open reduction and internal fixation with screws or wires. 1,2,4 -6 It is difficult to compare our results with other reports because of the variability of approaches and fixation techniques used and because many reports combine trans-scaphoid perilunate fracture-dislocations and perilunate dislocations that have a disruption of the scapholunate ligament, which require a very different repair.…”

Trans-scaphoid mid-carpal dislocation associated with radial styloid fracture: A rare injury

“…9 Russell reported that 58 of their 59 patients sustained a fracture dislocation of the carpus resulting from hyperextension of the wrist. 12 Campbell reported a fracture of the triquetrum associated with carpal dislocation in six of their 50 patients. 3 Bonin and Greening described a fracture of the triquetrum in association with a perilunate dislocation and a fracture of the proximal pole of the scaphoid.…”