Radiolunate Fusion After Pyogenic Arthritis Caused by Pinning for Scapholunate Dissociation

Infections associated with percutaneous pinning of the fingers occur in a certain percentage of cases; however, osteomyelitis rarely leads to more severe suppurative arthritis of the hand. A 26-year-old woman presented with scapholunate dissociation and underwent percutaneous pinning. Although some signs of infection were found around the pin site at five weeks, the pins were removed seven weeks postoperatively. At 10 weeks, she experienced severe wrist pain, with radiography, computed tomography, and magnetic resonance imaging confirming distractive changes in the lunate, radius, and pyogenic arthritis. Consequently, the infection was controlled; however, it led to radiolunate fusion. A case of percutaneous pinning followed by lunate osteomyelitis or pyogenic wrist arthritis leading to radial lunate fusion has not been reported previously. The pin should be removed immediately if it becomes infected.