An Unusual Transcarpi Fracture With Volar Lunate Dislocation In The Dominant Wrist Of A Manual Worker: Outcome Assessment At One Year

摘要

Fractures and dislocations within the carpus are high-energy injuries with extensive ligamentous disruption. They are usually unstable and require reduction and fixation with K wires and often open repair of the ruptured perilunate ligaments. They are associated with significant morbidity and loss of function and may require salvage wrist fusion if the outcome is unsatisfactory. The authors report an unusual case of transcarpi fracture with volar lunate dislocation and discuss management strategies,re-examine the classification of these injuries and report outcome at one year following conservative surgical wrist stabilization. Case Report A 25 year old manual ground worker fell from a height of ten feet onto his non dominant outstretched hand. He presented with a swollen and deformed wrist with no neurological deficit. Radiographs demonstrated fractures of the scaphoid, capitate and triquetrum. The carpus had displaced dorsally on the lunate.Fig.1 He underwent open reduction under general anaesthesia and K wire fixation of the fractures.Fig.2 Scaphoid cast was removed at eight weeks and he commenced physiotherapy.