Neglected isolated scaphoid dislocation

Abstract

The authors present a case of isolated scaphoid dislocation in a 40-year-old male that was undiagnosed for 2 months. The patient was treated by open reduction, Kirschner wire fixation, interosseous ligament repair using a suture anchor and Blatt's dorsal capsulodesis. At 6 years followup, his radiographs of wrist showed a normal carpal alignment with a scapholunate gap of 3 mm and no evidence of avascular necrosis (AVN) of the scaphoid.

Isolated Scaphoid Dislocation: A Case Report and Review of the Literature

“…3 Notwithstanding, Baek et al assert that accurate anatomic reduction, ligament repair, and secure fixation have the most impact on prognosis. 6 This case report would also support early operative intervention.…”

“…►Table 1 provides a comprehensive review of all of the reported cases. [1][2][3][4][5][6][7][8][9] The majority of scaphoid dislocations were seen in men (male:female ¼ 46:3); however, the age range was noted to be between 18 to 79 years. The main mechanism was a motor vehicle accident with a forced dorsiflexion and twisting motion of the wrist.…”

“…Nearly half of the cited cases had delayed diagnosis with the longest interval being 6 years. 2,3,5,6 Approximately, half of the cases were treated with operative fixation with only one case with a total dislocation noted to have avascular necrosis. 8 Even then the necrosis was relatively asymptomatic and limited to the proximal pole.…”

“…7 Ligamentous repair was not performed until 1985 by Amamilo et al and did not become preferred until after 2000. 3,5,6,8 Current literature favors ligament repair with open reduction to restore normal anatomy and preserve function. Despite the method of treatment and the totality of dislocation or ligamentous injuries, most patients preserve wrist motion but suffer from mild pain and decreased wrist range of motion.…”

Isolated Scaphoid Dislocation: A Case-Report

“…There are reports of late diagnosis, and both ligament reconstruction or carpal procedures, such as carpectomy of the proximal row, were performed. 6,7 It is important to remember that symptoms of compression of the median nerve could be present, especially in cases of volar dislocation 8 . Szabo et al 9 believe that the complexity of ligament injuries, assessed by radiography, can predict the need for open surgery.…”