Traumatic longitudinal disruption of the carpus

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Hand Surgery

Background:

• Traumatic longitudinal disruption of the carpus is a rare injury.
• It typically occurs through a weak point between the third and fourth metacarpals and the capitate and hamate bones.
• These injuries are often work-related and associated with broad crushing mechanisms to the hand and wrist.

Observation:

• Three cases of traumatic longitudinal carpal disruption are presented.
• All injuries were work-related, resulting from broad crushing injuries to the hand and wrist.
• The specific anatomical weak point involved the carpus, linking metacarpals to carpal bones.

Findings:

• Two patients underwent fasciotomies, carpal tunnel release, and excision of a fractured hamate hook.
• The third patient received carpal tunnel release and percutaneous pinning for a wide diastasis.
• Post-treatment, wrist motion improved in all patients.

Implications:

• Despite surgical interventions and restored wrist mobility, long-term functional deficits in pinch and grip strength were observed in all cases.
• This highlights potential challenges in achieving full functional recovery after severe carpal disruptions.
• Further research may be needed to optimize treatment strategies for improving grip and pinch strength post-injury.