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

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Wrist Biomechanics

Background:

• Perilunate dislocations (PLD) and perilunate fracture dislocations (PLFDs) are high-energy wrist injuries.
• Approximately 25% of PLD are missed during initial evaluation, leading to significant morbidity.
• Untreated perilunate injuries can cause avascular necrosis, arthritis, and chronic carpal tunnel syndrome.

Observation:

• A case of a 29-year-old male with a late-presenting Transscaphoid PLFD is reported.
• The patient underwent open reduction with a positive postoperative functional outcome.

Findings:

• Early diagnosis and intervention are critical for preventing avascular necrosis of the lunate and scaphoid.
• Prompt treatment of PLFDs reduces the risk of secondary osteoarthritis and long-term morbidity.
• Open reduction can yield good functional results in complex or late-presenting perilunate injuries.

Implications:

• Emphasizes the importance of timely diagnosis and management of perilunate injuries.
• Highlights the potential for good outcomes with surgical intervention even in late presentations.
• Recommends long-term follow-up to manage potential sequelae of perilunate injuries.