Transscaphoid Transcapitate Transtriquetral Perilunate Fracture–Dislocation: A Case Report

Surgical Treatment of Trans-Scaphoid, Transcapitate, Transtriquetral, Perilunate Fracture–Dislocation with Open Reduction, Internal Fixation and Lunotriquetral Ligament Repair

“…In respect of capitate fracture–dislocations, Fenton (1956) and Stein and Siegel (1969) advocated excision of the proximal pole, but other authors have recommended reserving this technique for use only in late cases with pain or limitation of motion (Adler and Shaftan, 1962; Cooney et al, 1987; Kaulesar Sukul and Johannes, 1992). Even when successful reduction and fixation of these lesions is carried out, early degenerative changes of the midcarpal joint can be expected (Leung et al, 2006).…”

“…To our knowledge, there are no reports of treatment of the serious and rare Johnson Stage III injury by internal fixation with screws and ligament repair (Leung et al, 2006; Marsh and Lampros, 1959; Weseley and Barenfeld, 1972). In our opinion, open reduction and internal fixation provides adequate stability of the scaphoid and capitate fractures.…”

“…To our knowledge, there are only three previous reports in the English literature of Stage III lesions (Leung et al, 2006; Marsh and Lampros, 1959; Weseley and Barenfeld, 1972). We report a fourth case of Johnson’s Stage III lesion of the carpus treated by open reduction and internal fixation.…”

Triple jeopardy: transscaphoid, transcapitate, transtriquetral, perilunate fracture dislocation

“…Various greater arc injury patterns have been identified, among which transscaphoid is the commonest, followed by transscaphoid, transcapitate, perilunate fracture dislocation [3, 4]. Other uncommon patterns include transscaphoid, transcapitate, transhamate fracture dislocation, transscaphoid, transcapitate, transtriquetral, perilunate fracture dislocation, and transscaphoid, transtriquetral, perilunate fracture dislocation [5–8]. …”

“…Transscaphoid, transcapitate, transtriquetral dislocation is a very rare pattern of carpal injury, with only two cases reported in the literature [5, 9]. A unique feature of this injury is its volar intercalated segment instability (VISI) pattern.…”