[Trans-scapho-perilunar dislocations with internal instability of the carpal bones]

Area of Science:

• Orthopedic Surgery
• Anatomy
• Biomechanics

Background:

• Carpal instability can result from perilunate dislocations with scaphoid fractures.
• The role of specific ligaments in carpal stability requires further elucidation.

Observation:

• Cadaveric and patient studies indicate the posterior triquetro-lunate ligament's significant contribution to carpal stability.
• A novel concept links wrist pronation and dorsal flexion during immobilization to instability after perilunate dislocations.

Findings:

• The posterior triquetro-lunate ligament is a key stabilizer of the carpus.
• Instability following perilunate dislocations with scaphoid fractures may be explained by a pronation-dorsal flexion mechanism.

Implications:

• Surgical recommendations include scaphoid fracture fixation with a screw and primary repair of the triquetro-lunate ligament.
• This approach may enhance stability and functional recovery in patients with these complex wrist injuries.