Abstract
Introduction The wrist represents a complex anatomic region in the upper extremity and a highly functional and intricate structural joint. Perilunate injuries have classically been described as involving a greater or lesser arc as described by Mayfield and imply a specific pattern of force transmission. The greater and lesser arc classifications do not include descriptions of when non-scaphoid carpal fractures occur as part of a perilunate injury. Methods/Results We present three cases of complex and rare perilunate fracture dislocation patterns and discuss the surgical management as a treatment model for these complex wrist injuries the trans-scaphoid, trans-capitate perilunate dislocation, the trans-scapholunate ligament, trans-capitate dislocation, and the trans-scaphoid, trans-triquetral perilunate dislocation. Discussion Although there is a low incidence of injury to non-scaphoid carpal bones, it is beneficial to understand the approach to the perilunate reduction and scaphoid fixation through a combined volar and dorsal approach, which will also allow for the reduction and fixation of more rare and complex carpal fractures.
Original language | English (US) |
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Pages (from-to) | 287-294 |
Number of pages | 8 |
Journal | Hand |
Volume | 6 |
Issue number | 3 |
DOIs | |
State | Published - Sep 2011 |
Keywords
- Carpal fracture
- Fracture dislocation
- Greater arc injury
- Mayfield classification
- Perilunate dislocation
- Trans-scaphoid
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine