Traumatic axial-ulnar disruption of the carpus

Six men and two women (aged 37 to 50) with traumatic axial-ulnar disruption of the carpus were evaluated at an average of 34 months following treatment. The injuries were caused by a broad, anteroposterior crushing force to the hand and wrist resulting from, in most cases, an industrial accident. Our treatment began 2 weeks postinjury in five patients and more than 1 month postinjury in three patients. Treatment techniques included closed or open reduction and plaster immobilization, primary or delayed skin grafting, immediate revascularization, and secondary techniques. Cooney's criteria rated treatment results as excellent in one patient, good in two, fair in two, and poor in three. Although four variations of this injury were identified, the pattern of disruption appeared to have no influence on the results. An early surgical procedure seems to be most effective.