Neglected dorsal dislocation of the scaphoid

Abstract

Isolated dislocation of the scaphoid is very rare. A 45-year old male, industrial worker reported two and half months after injury with wrist pain and swelling on the dorsum of left wrist. He was diagnosed as neglected dorsal dislocation of scaphoid. Proximal row carpectomy with capsular interposition was done stabilizing the distal carpus on the radius using Kirschner wires. At-12 months follow-up the patient had good wrist function and was satisfied with the outcome of the treatment. We hereby report this neglected dorsal dislocation of scaphoid in view of rarity and discuss the various options for management.

Isolated scaphoid dislocation: A case report and review of literature

“…Almost all of the dislocations were palmar and radial in orientation (Figure 6 ). Only one dorsal dislocation was reported[ 13 ]. That patient’s wrist was forced into dorsiflexion when he tried to prevent a 300 kg barrel from rolling over.…”

Isolated Scaphoid Dislocation: A Case-Report

“…There are reports of late diagnosis, and both ligament reconstruction or carpal procedures, such as carpectomy of the proximal row, were performed. 6,7 It is important to remember that symptoms of compression of the median nerve could be present, especially in cases of volar dislocation 8 . Szabo et al 9 believe that the complexity of ligament injuries, assessed by radiography, can predict the need for open surgery.…”

Complete dorsal dislocation of the carpal scaphoid with perilunate dorsal dislocation

“…Dorsal scaphoid dislocations are the rarest injury among scaphoid dislocations, and only four cases have been previously reported until now. 1 2 3 4 Two of them are isolated dorsal dislocation of scaphoid without other carpal injuries, and another two cases are dorsal dislocation of scaphoid associated with axial dislocation of carpus. 1 2 3 4 Complete dorsal dislocation of the scaphoid associated with dorsal perilunate dislocation without axial dissociation of carpus have not been reported until now to the best of our knowledge.…”

“…10 11 Proper treatment has been described as either closed or open reductions, regardless of the alignment achieved at the time of the reduction. 3 7 Interestingly, in cases where the scaphoid was completely dislocated and migrated out of the wrist area (a bare scaphoid), the clinical treatment results have been free of complications, including avascular necrosis; only one case of avascular necrosis of the scaphoid has been presented. These good outcomes may be the result of the rapid revascularization of the preserved intraosseous vascular supplies from the surrounding soft tissues.…”

“…Most dorsal dislocation of the carpal scaphoid has been reported with axial dissociation of carpus or without other carpal injury. 1 2 3 4 Complete dorsal dislocation of the carpal scaphoid associated with dorsal perilunate dislocation without axial dissociation of carpus is unique carpal injury which have not been reported until now to the best of our knowledge. We report such a case and discuss the injury mechanism, management, and outcome.…”