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Arthroscopic Reduction and Internal Fixation for Peritrapezium Traumatic Axial Carpal Dislocation: A Case Report
Shogo Shibata1, Koichi Yano1, Yasunori Kaneshiro1
1Department of Orthopaedic Surgery, Seikeikai Hospital, Sakai, JPN.
Cureus
|December 14, 2022
Summary
This study introduces arthroscopy-assisted surgery for rare axial carpal dislocations. This minimally invasive technique successfully restored carpal anatomy and function in a patient with a peritrapezium fracture-dislocation.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Arthroscopy
Background:
- Axial carpal dislocations and fracture-dislocations are uncommon injuries affecting the carpal arches.
- Traditional treatments include open or closed reduction with internal fixation.
- Arthroscopic surgical treatment for these injuries has not been previously documented.
Observation:
- A 54-year-old male sustained a peritrapezium axial carpal dislocation.
- Severe hand swelling necessitated a minimally invasive surgical approach.
- Arthroscopy-assisted reduction using midcarpal portals was performed.
Findings:
- The procedure involved anatomical reduction of the trapezium fracture-dislocation and fixation with wires.
- Postoperative recovery included wire removal at six weeks and initiation of wrist range-of-motion exercises.
- One-year follow-up showed the patient was asymptomatic with full daily activity and work capability.
- Computer tomography confirmed an intact carpal arch and no signs of traumatic arthrosis.
Implications:
- Arthroscopy-assisted surgery offers a viable minimally invasive option for treating axial carpal dislocations and fracture-dislocations.
- This technique allows for precise anatomical reduction and assessment of the injury.
- It potentially leads to excellent functional recovery and preservation of joint integrity.
