In contrast to triquetral fractures, dislocations of the triquetrum are very uncommon because of the very strong ligamentous support. They occasionally occur in association with complex wrist injuries, isolated dislocations however are extremely rare. We report a case of a male athlete who sustained an isolated volar dislocation of the triquetrum. The injury was treated by open reduction, fixation with Kirschnerwires and direct repair of torn ligaments. Kirschner-wires were removed after 6 weeks and physiotherapy was started. At 3 years follow-up he reported to be free of pain and showed only slightly restricted grip strength and range of motion when compared to his uninjured hand. A review of the literature indicates that final outcomes are usually satisfactory if prompt diagnosis and treatment occurs. However persistent pain and impaired hand function may result because of delayed diagnosis or insufficient repair of associated ligament injuries.
Acute or chronic arterial thrombose due to repetitive blunt trauma to the palm of the hand is a rare occupational vascular disease. In most of the cases it affects the ulnar artery and its superficial palmar branch. Repetitive crush is pathogenic and the unique anatomy of the superficial branch of the ulnar artery lying next to the hook of hamate is causative. In rare cases it may affect the superficial palmar branch of the radial artery, called thenar hammer syndrome. The combination of both is an absolute rarity. Both syndromes are occupational diseases in workers using the hand as a hammer. Patients typically present with Raynaud phenomenon or complain about ischemic pain, cold intolerance, or cyanosis. The gold standard in diagnosis is the angiography. Surgical or conservative treatment can be performed successfully. We present a case of combined thenar and hypothenar hammer and a brief review of the literature.
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