[Clinical findings and treatment of perilunar dislocations and dislocation fractures]

[Radiocarpal dislocations and fracture dislocations]

Radiocarpal dislocations and fracture dislocations are rare but always severe and complex injuries. They occur frequently in young and active patients as a result of high energy accidents. A detailed clinical and imaging examination and an accurate classification leads to a suitable and mostly surgical treatment strategy. The strategy should consider the most important components of the injury, the bony, the ligamentous and the intracarpal lesions. Delayed sequelae, residual pain and functional impairment are frequent after these severe injuries, but with adequate treatment, good, even long-term functional results are possible.

First-stage scapholunate fusion for the treatment of a chronic lunate dislocation: A case report

RATIONALE

Lunate dislocation is a rare injury to the wrist caused by high-energy trauma, and poor prognosis is often associated with missed initial diagnosis. To date, there is no consensus regarding an effective treatment plan for such cases.

PATIENT CONCERNS

Here, we describe the case of a 36-year-old man who presented with lunate dislocation following a delay in diagnosis of over 7 weeks, and further illuminate its diagnosis and treatment.

DIAGNOSIS

The diagnosis of chronic lunate dislocation was rendered.

INTERVENTIONS

The patient was treated using reduction via the dorsal approach brachial plexus anesthesia. After the reduction, a headless compression screw fixation was performed for first-stage scapholunate fusion, and Kirschner wire fixation of the lunate-triquetrum-hamate was used to stabilize the distal and proximal carpal rows.

OUTCOMES

The patient was followed up for 1 year and showed wrist function recovered well; radiographic examination showed no lunate dislocation and successful scapholunate bony fusion. A satisfactory outcome was achieved.

LESSONS

The case study presented here provide evidence that performing an effective first-stage scapholunate fusion is recommended to achieve better therapeutic outcomes for a chronic lunate dislocation. Furthermore, this approach led to a good long-term clinical outcome in our case.