Proximal row transcarpal fracture from a punching injury

We describe an unusual case of a 31-year-old woman who injured the right dominant wrist when she punched an assailant's shoulder. She described a mechanism of direct compression, with the wrist in hyperextension, radial deviation and the forearm in pronation. She sustained an oblique transverse fracture of the proximal pole of the scaphoid and a coronal plane fracture of the lunate and the triquetrum. This unusual proximal row transcarpal fracture is in conflict with the Mayfield sequence and was caused by a low velocity injury.