Complex and rare fracture patterns in perilunate dislocations

John G. Apostolides, Scott D. Lifchez, Michael R. Christy

Research output: Contribution to journalArticlepeer-review

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 languageEnglish (US)
Pages (from-to)287-294
Number of pages8
JournalHand
Volume6
Issue number3
DOIs
StatePublished - Sep 1 2011

Keywords

  • Carpal fracture
  • Fracture dislocation
  • Greater arc injury
  • Mayfield classification
  • Perilunate dislocation
  • Trans-scaphoid

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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