Total Scapholunate Dislocation With Complete Scaphoid Extrusion: Case Report

Domeshek, Leahthan F.; Harenberg, P.S.; Rineer, Craig A.; Hadeed, Josef; Marcus, Jeffrey R.; Erdmann, Detlev

doi:10.1016/j.jhsa.2009.09.015

Cited by 16 publications

(14 citation statements)

References 16 publications

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“…PRC on a patient with a scapholunate dislocation and complete scaphoid extrusion resulted in a good clinical outcome [6], suggesting that PRC may eliminate avascular necrosis and avoid additional surgery in patients with this type of injury. However, although PRC has shown satisfactory clinical outcomes, postoperative ROM and grip strength averaged 50–70% and 60–90%, respectively, compared with the healthy side [9], outcomes similar to those observed in our patient.…”

Section: Discussionmentioning

confidence: 99%

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Palmar-divergent dislocation of the scaphoid and the lunate

Komura

Yokoi

Suzuki

2011

J Orthopaed Traumatol

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We describe a patient with palmar-divergent dislocation of the scaphoid and lunate. After successful closed reduction, the scapholunate and lunotriquetral ligaments were sutured through the dorsal approach, and the anterior capsule was sutured through the palmar approach. The scapholunate and lunotriquetral joints were fixed with Kirschner wires for 7 weeks. At the 1-year follow-up, magnetic resonance imaging showed no evidence of avascular necrosis of the scaphoid or lunate, and radiographs showed no evidence of the dorsal and volar intercalated segment instability patterns associated with carpal instability. However, flexion of the scaphoid and a break in Gilula’s line remained. To our knowledge, this is the first report showing treatment of palmar-divergent dislocation of the scaphoid and lunate by suturing the carpal interosseous ligaments.

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Section: Discussionmentioning

confidence: 99%

“…Ten patients with dislocation of the scaphoid and lunate as a unit have been described to date, as well as six patients with divergent dislocation [1–6]. The patient described here is therefore the seventh with palmar-divergent dislocation of the scaphoid and lunate.…”

Section: Introductionmentioning

confidence: 99%

Palmar-divergent dislocation of the scaphoid and the lunate

Komura

Yokoi

Suzuki

2011

J Orthopaed Traumatol

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“…Simultaneous palmar dislocation of scaphoid and lunate generally resulting from high-energy trauma is extremely rare [1][2][3][4][5][6][7][8][9] and classified into two types depending on whether the scapholunate ligament is intact or not: 1) palmar dislocation as a unit and 2) palmar divergent dislocation [4][5][6][7]. Komura et al [7] reviewed the literature in 2011 and added a seventh case of simultaneous palmar divergent dislocations of scaphoid and lunate.…”

Section: Introductionmentioning

confidence: 99%

“…Komura et al [7] reviewed the literature in 2011 and added a seventh case of simultaneous palmar divergent dislocations of scaphoid and lunate. Since then, the other two cases have been reported [8,9], increasing the number of the patients with palmar divergent dislocations of scaphoid and lunate to nine [1][2][3][4][5][6][7][8][9]. Of the nine cases, one case presented with ipsilateral radial head fracture [1] and another with trapezium fracture [4].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous palmar divergent dislocation of scaphoid and lunate concurrent with i psilateral humeroradial joint dislocation and humerus shaft fracture: report a rare case and add a new subtype

Feng

Xia

Liu

et al. 2020

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Background: Simultaneous palmar dislocation of scaphoid and lunate is a rare condition generally resulting from high-energy trauma and usually classified into two types. The literature has only reported nine patients with palmar divergent dislocation of scaphoid and lunate. Here we we present a case of accompanied ipsilateral humeroradial joint dislocation and open humeral shaft fracture caused by the same violence travelling from the wrist. Considering the emerging cases with their own characteristics, we suggest this severer injury be expanded into the third type of palmar dislocation of scaphoid and lunate. Case presentation: A 31-year-old male who fell from a three-storey building, with his right wrist directly hitting the ground, was admitted to the orthopaedic department of our hospital. Physical and radiographic examinations defined simultaneous palmar divergent dislocations of scaphoid and lunate concurrent with ipsilateral humeroradial joint dislocation and open humeral shaft fracture. After debridement and internal fixation for humerus and close reduction for humeroradial joint, the scaphoid and lunate were treated with open reduction and fixation by Kirschner’s wires, and the palmar scapholunate ligament and anterior capsule were repaired through volar approach. After a 3-year follow-up, his humeral fracture healed without recurrent dislocations, collapse or avascular necrosis of scapholunate. Favorable hand function regained . Conclusions: Palmar divergent dislocation of scaphoid and lunate caused by considerable violence is rare and appropriate to urgent open reduction and fixation with Kirschner’s wires and repair of the stronger palmar scapholunate ligament through single volar approach. When the residual violence continues to transmit to the upper extremity, ipsilateral dislocation or fracture may occur. We advise that this complex injury be classified into a third subtype of simultaneous palmar dislocation of scaphoid and lunate to avoid misdiagnosis.

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“…[1] Isolated dislocation of carpal bone has been described of which lunate dislocation is the most common isolated carpal bone dislocation. Rare patterns involve the dislocation of the scaphoid [2] pisiform [3–6] triquetrum [7] trapezium [8] trapezoid [9] capitate [10] hammate [11] and scapholunate[12] as a unit. Dislocation of the proximal row is not described in English literature.…”

Section: Introductionmentioning

confidence: 99%

Trans-scaphoid dislocation of the proximal row: a case report

Ansari¹,

Kotwal²,

Rijal³

2013

Pan Afr Med J

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This report is of a 32 year old man who presented with complains of pain, swelling and deformity of right wrist of four weeks duration. He gave history of road traffic accident four weeks back leading to injury to right wrist; Preoperative radiographs and C.T. scan images were suggestive of trans-scaphoid dislocation of the proximal row of wrist. A volar and dorsal approach were used to reduce this complex dislocation but was not successful. Wrist arthodesis was performed after doing proximal row carpectomy. One year follow-up of the patient showed fair result with grip strength of 85% to contralateral side and modified Mayo wrist score of 65 at one year.

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Total Scapholunate Dislocation With Complete Scaphoid Extrusion: Case Report

Cited by 16 publications

References 16 publications

Palmar-divergent dislocation of the scaphoid and the lunate

Palmar-divergent dislocation of the scaphoid and the lunate

Simultaneous palmar divergent dislocation of scaphoid and lunate concurrent with i psilateral humeroradial joint dislocation and humerus shaft fracture: report a rare case and add a new subtype

Trans-scaphoid dislocation of the proximal row: a case report

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