Treatment of dislocations and dislocationfractures of carpal bones

Abstract

One hundred eighty seven patients with dislocation and dislocation-fracture of carpal bones were treated. There were 81 patients with acute injuries and 106 patients with old ones. In 33.6% of cases injuries of carpal bones were combined with fractures of other bones forming wrist joint. In 20.3% of cases neurologic deficit was detected. Clinical manifestations, diagnosis and peculiarities of treatment were presented. Authors considered the conduction anesthesia to be the best analgetic method. In acute trauma close manual reduction was indicated. Indications for operative treatment were non-reduced dislocations and dislocation-fractures as well as impossibility of reduction of scapoid bone. In case of wrist joint instability temporary Stabilization of wrist joint by К-wires should be performed. In old injuries two-step treatment was recommended: 1st step - distraction of the wrist joint; 2nd step - open reduction of dislocation and dislocation-fracture and osteosynthesis of the scapoid bone. Good and satisfactory results were achieved in 91% of cases.