Rowan CH, Downing ND. BMJ Case Rep 2017. doi:10.1136/bcr-2017-221041 Description Perilunate dislocations are uncommon high-energy injuries which are missed in approximately 25% of cases on initial presentation. We present the X-rays of a 25-year-old man who fell from a height of approximately 2 metres onto an extended wrist. Plain radiographs (figure 1) show classical signs of a trans-scaphoid ...

The wrist represents a complex anatomic region in the human extremity and a highly functional and intricate structural joint. Most perilunate injuries result from a staged disruption of the ligamentous structures. Forces may be directed through the carpal bones themselves resulting in a fracture. Early anatomic reduction of any carpal malalignment is of the utmost importance. Unfortunately, eve...

Background: Trans-scaphoid lunate dislocation is an orthopaedic injury, mostly because of high energy trauma. Due to subtle clinical and radiological findings, it might be easily left undiagnosed, with estimated 25% cases are missed at initial assessment in emergency department. Non-union scaphoid, which accounts for 5-10% all scaphoid fractures treated K-wires fixation, occurs young active ind...

A classification and plan of management for carpal dislocations are presented, based upon the following basic premises: perilunate and lunate dislocations are different stages of the same injury and are therefore managed identically; displacement may be either dorsal or volar; anatomic restoration of the 3 key elements (scaphoid, lunate, and capitate) is essential. Following initial closed redu...

A 32 year old man, right-handed soldier, was admitted to Emergency Department two hours after undergoing right wrist injury following a 2 meter fall onto the hand, in hyperextension. Clinical examination revealed a deformity of the wrist with an obvious open lunate enucleation (A). The neurovascular status was intact. Standard radiograph of the wrist demonstrated a completely enucleated lunate,...

Isolated dislocation of the carpal scaphoid is a rare injury. Such dislocation is extremely rare. In this article the authors report a twenty-eight-year-old man with isolated dislocation of the scaphoid with associating radial styloid fracture. We manage the patient with open reduction and Kirschner wire fixation. One year later there is a good functional and radiographic result.

INTRODUCTION Perilunate and lunate dislocations are uncommon high energy injuries and have extensive soft tissue, cartilaginous and bony damage. The most common pattern is trans-scaphoid perilunate fracture dislocation which constitutes approximately 50% of these injuries. Unusual injury pattern like Scaphocapitate syndrome can occur with fracture through scaphoid waist and capitate that rotate...

Up to 30 % of acute scaphoid fractures are missed in conventional radiography. CT and MRI should be early performed in the diagnostic workflow, when radiograms (dorsopalmar, lateral and Stecher's views) are negative or inconclusive in fracture detection. Significance of CT is different from that of MRI: Sensitivity of CT imaging (85 to 95 %) is superior to conventional radiography (about 70 %),...

SUMMARY: A rare case of trans-radial styloid, trans-scaphoid. trans-triquetral perilunate dislocation is described. The injury was treated by reduction and internal fixation using a Herbert screw and Kirschner wire. A good functional result was achieved. A review of the literature illustrates that early surgery is recommended. Alternative su rgical approaches are discussed. Case Report A twenty...