Trans-Scaphoid Perilunate Fracture Dislocation Managed With Open Reduction: A Case Report

Perilunate dislocations (PLD) and perilunate fracture dislocations (PLFDs) are complex wrist injuries, resulting from high energy trauma such as motor vehicle accidents, fall from height, and extreme athletic injuries. About a fourth (25%) of PLD are missed at the initial presentation. Urgent closed reduction should be attempted in the emergency room itself to minimize the morbidity due the condition. However, if it is unstable or irreducible the patient the can be posted for open reduction. Perilunate injuries can result in poor functional results, if left untreated patients may have long-term morbidity due to complications such as avascular necrosis of lunate and scaphoid, post-traumatic arthritis, chronic carpal tunnel syndrome, and sympathetic dystrophy. Patient outcome even after treatment is also controversial.

We have brought one such case where the patient, a 29-year-old male suffered a Transscaphoid PLFD, presented to us late and was treated with open reduction with good functional outcome postoperatively.

Early and prompt diagnosis followed by early intervention is necessary to prevent the potential risk of avascular necrosis of lunate and scaphoid and secondary osteoarthritis in PLFDs to reduce the long-term morbidity and long-term follow-up is advisable to diagnose and treat the long-term sequelae.