Case: We describe an intercarpal dislocation with proximal and rotatory displacement of the lunate and with volar and radial dislocation of the scaphoid; both bones were stripped of soft tissue. Treatment involved ORIF (open reduction and internal fixation). Three years postoperatively, the patient had a DASH (Disabilities of the Arm, Shoulder and Hand) score of 10, equivalent grip strength and 50% wrist palmar flexion and 98% wrist dorsiflexion compared with the uninjured side, and radiographic evidence of posttraumatic arthritis.
Conclusion: Treatment of simultaneous divergent lunate and scaphoid dislocation with loss of nearly all soft-tissue attachments and vascular supply by means of ORIF and repair of soft-tissue structures can result in a favorable intermediate-term functional outcome and may be superior to other salvage procedures such as proximal row carpectomy.
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http://dx.doi.org/10.2106/JBJS.CC.15.00112 | DOI Listing |
J Hand Surg Glob Online
November 2024
Department of Orthopedic Surgery, Crystal Clinic, Akron, OH.
This surgical technique article describes the anatomic C scapholunate reconstruction technique. It is indicated for complete acute or chronic scapholunate ligament dissociation. The technique addresses severe scapholunate interval gapping, ulnar translocation of the lunate, and rotational/dorsal intercalated segment instability.
View Article and Find Full Text PDFJ Hand Microsurg
December 2024
Department of Orthopedic and Trauma Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia.
Purpose: This biomechanical study aimed to assess the change in the radioscaphoid and the radiolunate angles during wrist extension to flexion in scapholunate instability compared to the healthy wrist.
Methods: Dynamic CT scans of 19 participants with no history of wrist pathology and 19 patients with scapholunate instability without degenerative changes were selected. Motion sequence studied was wrist extension to flexion.
J Hand Surg Am
December 2024
Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery, Emory University, Atlanta, GA. Electronic address:
The lunotriquetral intercarpal ligament (LTIL) is an important structure that equalizes the forces on the lunate imparted through the scapholunate intercarpal ligament. The extension moment of the triquetrum balances the flexion force of the scaphoid, positioning the lunate for efficient load transfer from the hand to the wrist. In contrast to the scapholunate intercarpal ligament, the LTIL is strongest volarly, with the most critical region being associated with the volar ulnocapitate ligament.
View Article and Find Full Text PDFJ Hand Surg Am
November 2024
Department of Hand Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Mehiläinen Helsinki Hospital, Helsinki, Finland.
Purpose: Scapholunate dissociation frequently results in malalignment and scapholunate advanced collapse (SLAC). Previous analyses have relied on visual observations of carpal angles among the scaphoid, lunate, and capitate on lateral radiographs. However, the 3-dimensional carpal alignment during SLAC progression remains unclear.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!