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Irreducible trans-scaphoid perilunate dislocation.

M S Jasmine1, J W Packer, G S Edwards

  • 1Division of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill.

The Journal of Hand Surgery
|March 1, 1988
PubMed
Summary
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Irreducible trans-scaphoid perilunate dislocations can be caused by soft tissue interposition, preventing joint reduction. A dorsal surgical approach is recommended for open reduction when closed manipulation fails.

Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Anatomy

Background:

  • Perilunate dislocations are complex wrist injuries.
  • Trans-scaphoid perilunate dislocation involves a fracture of the scaphoid bone.
  • Irreducibility poses significant challenges in treatment.

Observation:

  • Two cases of irreducible trans-scaphoid perilunate dislocation were analyzed.
  • Soft tissue interposition was identified as the cause of irreducibility.
  • Specific entrapment involved the dorsal capsule impinging on the distal scaphoid fragment or between the capitate and lunate.

Findings:

  • Soft tissue interposition, particularly of the dorsal capsule, prevents closed reduction of the capitolunate and scaphoid components.
  • The exact mechanism of entrapment varied between the two described cases.

Related Experiment Videos

  • Successful open reduction requires addressing the interposed soft tissues.

    • Implications:

    • A dorsal surgical approach is recommended for open reduction in irreducible trans-scaphoid perilunate dislocations.
    • Understanding the specific soft tissue interposition guides surgical strategy.
    • This approach facilitates anatomical reduction and potentially improves wrist function outcomes.