Palmar dislocation of scaphoid and lunate as a unit: Case report with special reference to carpal instability and treatment

Total Scapholunate Dislocation With Complete Scaphoid Extrusion: Case Report

“…11 However, although detailed wrist position at the time of impact is reported in select cases, 3 it cannot be ascertained with certainty in many. 5,6,8,9,14 In the current case, the injury resulted from a substantial fall, with uncertain wrist position at the time of impact. However, the volar laceration suggests substantial contact between the road surface and the volar aspect of the arm.…”

“…Most previous cases (including cases in which the scaphoid and lunate dislocated as a unit and cases in which they were dissociated) were treated with some type of closed or open reduction of the carpals. In many, late malalignment of carpals 6,9,13,14 (regardless of alignment achieved at the time of reduction) occurred, and some were complicated by avascular necrosis of the lunate 1 to 5 months after injury. 5,9 The main contraindication for PRC remains the presence of severe degenerative or traumatic changes in the cartilaginous surface of the capitate head.…”

“…In many, late malalignment of carpals 6,9,13,14 (regardless of alignment achieved at the time of reduction) occurred, and some were complicated by avascular necrosis of the lunate 1 to 5 months after injury. 5,9 The main contraindication for PRC remains the presence of severe degenerative or traumatic changes in the cartilaginous surface of the capitate head. In the presented case, a small defect located in the capitate's articular cartilage was deemed acceptable.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] We have found only 17 reported cases in the literature that involve simultaneous dislocation of the scaphoid and lunate. 5,6,8,9,[12][13][14] In 11 of these cases, the 2 carpal bones dislocate as a unit. 5,9,13,14 In 2003, Kang et al reported only the sixth case of simultaneous, independent dislocation, in which scaphoid and lunate were dissociated from each other.…”

“…5,6,8,9,[12][13][14] In 11 of these cases, the 2 carpal bones dislocate as a unit. 5,9,13,14 In 2003, Kang et al reported only the sixth case of simultaneous, independent dislocation, in which scaphoid and lunate were dissociated from each other. 8 We present an unusual case in which not only did independent dislocation of the scaphoid and lunate occur, but also the scaphoid was completely extruded from the wrist, to lie completely free from the patient's body.…”