Dorsal transscaphoid perilunate dislocation through an isolated scaphoid non-union

Area of Science:

• Orthopedic Surgery
• Traumatology
• Wrist Biomechanics

Background:

• Perilunate dislocations are severe wrist injuries often resulting from high-energy trauma.
• Scaphoid non-union, a failure of fracture healing, can alter wrist mechanics and stability.
• Dorsal transscaphoid perilunate dislocations represent a specific and complex subset of these injuries.

Observation:

• A patient presented with a traumatic dorsal transscaphoid perilunate dislocation.
• Radiographic and intraoperative evaluation revealed an underlying, previously undiagnosed isolated scaphoid non-union.
• The dislocation mechanism was directly linked to the instability caused by the scaphoid non-union.

Findings:

• This represents the first reported instance of a dorsal transscaphoid perilunate dislocation occurring secondary to an isolated scaphoid non-union.
• The pre-existing scaphoid non-union served as a critical point of failure, facilitating the dislocation pathway.
• The unique injury pattern highlights the potential for catastrophic instability in wrists with occult scaphoid non-unions.

Implications:

• This case expands the understanding of complex wrist injury mechanisms.
• It underscores the importance of thorough evaluation for scaphoid non-union in patients presenting with severe wrist trauma.
• Recognition of this specific injury pattern may influence surgical planning and treatment strategies for similar complex dislocations.