A 50 year-old manual worker suftered high-energy axial trauma to the first ray. One month after injury he was assessed in our clinic for wrist. pain and loss of thumb motion. Radiographs and a CT scan with three-dimensional reconstruction showed a fracture of the trapezium and a dorsal dislocation of the STT joint (Fig 1). Six weeks after the initial injury, reduction was done under general anaesthesia. Intraoperatively, an incomplete undisplaced fracture of the scaphoid with bone loss was discovered unexpectedly. K-wire fixation and grafting with devascularised bone were done immediately. A thumb spica splint was applied for 7 weeks and the K-wires were removed at 8 weeks.
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