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Total Scapholunate Extrusion Into the Forearm in a Transscaphoid, Transcapitate Perilunate Fracture Dislocation: A
Kitty Wu1, George S Athwal2, Douglas Ross2
1Department of Plastic and Reconstructive Surgery, Western University, London, Ontario Canada.
JBJS Case Connector
|September 10, 2020
Summary
A complex wrist fracture-dislocation treated with open reduction and internal fixation (ORIF) resulted in successful bone healing and revascularization of the lunate. This surgical approach offers a positive outcome for severe wrist injuries.
Area of Science:
- Orthopedic Surgery
- Trauma Care
- Hand and Wrist Surgery
Background:
- Perilunate fracture-dislocations are severe wrist injuries often resulting from high-energy trauma.
- Transscaphoid transcapitate perilunate fracture-dislocation involves complex instability and potential neurovascular compromise.
Observation:
- A 50-year-old female motorcyclist sustained a complete extrusion of the scaphoid and lunate into the forearm.
- Urgent open reduction and internal fixation (ORIF) was performed with screw and Kirschner wire fixation.
Findings:
- Radiographs at 1-year postoperatively demonstrated healing of the scaphoid and capitate fractures.
- No signs of avascular necrosis were observed in the lunate, indicating successful revascularization.
Implications:
- ORIF is an effective treatment for complex transscaphoid transcapitate perilunate fracture-dislocations.
- Successful surgical management can restore wrist function and prevent long-term complications like avascular necrosis.
