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Open Trans-Scaphoid Transcapitate Perilunate Fracture-Dislocation: A Case Report
Abdulrahman J Korkoman1,2, Sara Alrajhi3, Abdulaziz A AlQahtani2
1Orthopedic Surgery, University of Bisha, Bisha, SAU.
Cureus
|June 14, 2023
Summary
Perilunate dislocations are rare but often missed wrist injuries. Prompt diagnosis and surgical repair, including open reduction and internal fixation, yield excellent long-term outcomes.
Area of Science:
- Orthopedic Surgery
- Trauma Care
Background:
- Perilunate dislocations and fracture-dislocations are uncommon but critical wrist injuries.
- These injuries are frequently misdiagnosed during initial medical assessments.
Observation:
- A case study of a 37-year-old male with an open perilunate fracture-dislocation following trauma is presented.
- The patient required multiple debridements, external fixation, and open reduction with internal fixation using headless screws for the scaphoid and capitate.
Findings:
- The surgical approach involved a combined dual (volar and dorsal) incision for optimal exposure and fixation.
- Post-operative physiotherapy was initiated eight weeks after the definitive surgery.
- A six-year follow-up revealed a satisfactory outcome with an excellent Mayo wrist score.
Implications:
- Perilunate injuries necessitate inclusion in the differential diagnosis for all wrist trauma.
- Timely diagnosis and appropriate treatment, specifically open reduction and internal fixation via a combined approach, are crucial for optimal patient recovery.
