TRAUMATIC SCAPHOLUNATE DISSOCIATION--CASE REPORT

Perilunate injuries occur after an impact trauma to the wrist. The recognition of these lesions and immediate treatment are the two essential conditions to ensure the best possible outcome. The first therapeutic step is the restoration of anatomical joint relationships of the carpus followed by percutaneous pinning or internal fixation required for maintaining the congruence this segment. Despite correct diagnosis and approach in these cases the prognosis is often encumbered by decreased range of motion, loss of grip strength and finally the onset of osteoarthritis. Scapholunate dissociation is the most frequent pattern of carpal instability. We report the case of a 53-year-old woman diagnosed with scapholunate dissociation resulting from an injury caused by fall from the same level on the outstretched right hand (dominant hand). Surgery was performed 48 hours post-injury and consisted in external reduction followed after the restoration of the anatomical joint relationships in the right wrist by percutaneous pinning. Postoperatively the wrist was immobilized in brachipalmar cast for 8 weeks and arthrosynthesis pins were removed. The patient was reassessed at 6 months postoperatively by clinical and radiological evaluations and the functional outcome was good.