Fratura‐luxa??o transtriquetral peri‐hamato: relato de caso ☆

摘要

Resumo O punho é uma regi?o muito vulnerável a traumas de extremidade. Entre tais les?es, as fraturas do piramidal (ou triquetrum), associadas à luxa??o do hamato e à instabilidade carpal, s?o pouco frequentes. Geralmente relacionadas a traumatismos de alta energia, podem estar associadas a déficit neurovascular, miotendíneo, les?es de pele ou em outros ossos do carpo. Assim, neste relato, apresenta‐se um desses casos raros de fratura‐luxa??o transtriquetral peri‐hamato com instabilidade carpal, diagnosticadas por radiografias do punho direito de um paciente que apresentava dor, edema e limita??o da flexoextens?o do carpo após trauma na regi?o. As etapas do atendimento foram descritas desde a consulta inicial até o tratamento cirúrgico e a fisioterapia, que culminaram com a restaura??o da for?a e da amplitude de movimento do punho. Abstract The wrist is a region that is very vulnerable to injuries of the extremities. Among these injuries, fractures of the pyramidal bone (or triquetrum) in association with dislocation of the hamate and carpal instability are uncommon. They are generally correlated with high‐energy trauma and may be associated with neurovascular deficits, muscle‐tendon disorders, skin lesions or injuries to other carpal bones. Thus, in this report, one of these rare cases of transtriquetral perihamate fracture‐dislocation with carpal instability is presented, diagnosed by means of radiography on the right wrist of the patient who presented pain, edema and limitation of flexion‐extension of the carpus after trauma to the region. The stages of attending to the case are described, from the initial consultation to the surgical treatment and physiotherapy, which culminated in restoration of the strength and range of motion of the wrist.