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[Dorsal scapho-lunate bone dislocation]

P Kujath

    Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
    |January 1, 1982
    PubMed
    Summary
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    A dorsal scapho-lunate dislocation, a severe wrist injury, can lead to long-term carpal instability despite initial successful treatment. This case highlights the importance of long-term monitoring for wrist injuries.

    Area of Science:

    • Orthopedic Surgery
    • Radiology
    • Sports Medicine

    Background:

    • Scapho-lunate dislocation is a significant wrist injury often caused by high-energy trauma.
    • Understanding the complex biomechanics of the wrist is crucial for diagnosing and treating carpal dislocations.

    Observation:

    • A patient sustained a dorsal scapho-lunate dislocation due to forced wrist hyperflexion.
    • Radiographic evidence showed a dorsally displaced lunate and palmar displacement of the distal carpus, indicating a combined dorsal lunate and palmar perilunate dislocation.

    Findings:

    • Initial treatment involved closed reduction, a gauntlet cast, and physical therapy, achieving a seemingly successful outcome.
    • A six-year follow-up revealed a palmar carpal instability, despite the absence of subjective patient complaints.

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    Implications:

    • This case underscores the potential for delayed or occult carpal instability following initial management of complex wrist dislocations.
    • Long-term radiological surveillance may be necessary to detect subtle carpal instabilities not apparent clinically.
    • The findings suggest that even with successful initial reduction, underlying carpal instability can persist, impacting wrist function over time.