J Korean Soc Surg Hand.  2015 Sep;20(3):127-132. 10.12790/jkssh.2015.20.3.127.

Bilateral Trans-Scaphoid Perilunate Fracture Dislocation

• Chae SB
• Nam JH

• KMID: 2068818
• DOI: http://doi.org/10.12790/jkssh.2015.20.3.127

Abstract

Bilateral trans-scaphoid perilunate fracture dislocations are uncommon and have been rarely reported in the literature. Furthermore, it is more difficult to manage in the case of Fenton's syndrome (scaphocapitate fracture syndrome, trans-scaphoid trans-capitate fracture dislocation). These injuries occur after a high-energy trauma caused by fall from height or vehicular accidents. These fracture dislocation patterns have very few reported cases in the literature and little information as to the diagnosis, management, and surgical approach for treatment. We present a case of scaphocapitate fracture syndrome on the right hand and trans-scaphoid trans-triquetral perilunate injury on the left hand at the same time.

Keyword

Scaphoid; Perilunate; Fracture-dislocation; Open reduction and internal fixation

MeSH Terms

Diagnosis
Dislocations*
Hand

Figure

• 

  Fig. 1. (A, B) Displaced fracture of the scaphoid and the capitate with perilunate dislocation of the carpus. There is a mid-waist scaphoid fracture, linear hamate fracture and a proximal pole capitate fracture with 22° translation of the proximal capitate fragment. (C, D) Postoperative X-ray image of the right wrist.

• 

  Fig. 2. (A, B) The roentgenograms images reveals dorsal perilunate dislocation associated with scaphoid and triquetral fractures of the left wrist. (C, D) Postoperative X-ray image of the left wrist.

• 

  Fig. 3. (A, B) Postoperative X-ray images of the right wrist after bone graft with screw change. We could find the early arthritic change of the mid-carpal joint.

• 

  Fig. 4. (A-D) 23 months later from the accident.

• 

  Fig. 5. Transmission of the energy with radial deviation of the right wrist ➀ Turning steering wheel to radial side ➁ The energy transmission. S, scaphoid; C, capitate; L, lunate.

Reference

References

1. Melsom DS, Leslie IJ. Carpal dislocations. Curr Orthop. 2007; 21:288–97.

2. Hamdi MF. The scaphocapitate fracture syndrome: report of a case and a review of the literature. Musculoskelet Surg. 2012; 96:223–6.

3. Kaneko K, Miyazaki H, Yamaguchi T, Yanagihara Y, Kurosawa H. Bilateral transcapholunate dislocation. Chir Main. 2000; 19:263–8.

4. Saxena V, Pradhan P, Yadav A, Mehrotra V. Bilateral symmetrical trans-scaphoid perilunate dislocation: a rare injury. J Clin Orthop Trauma. 2011; 2:51–3.

5. Barros JW, Oliveira DJ, Fernandes CD. Bilateral transscapholunate dislocations. J Hand Surg Br. 1997; 22:169–72.

6. Kumar A, Thomas AP. Scapho-capitate fracture syndrome: a case report. Acta Orthop Belg. 2001; 67:185–9.

7. Harrington P, Quinlan WB. Palmar lunate transscaphoid, trans-triquetral fracture-dislocation. J Hand Surg Br. 1999; 24:493–6.

8. Apostolides JG, Lifchez SD, Christy MR. Complex and rare fracture patterns in perilunate dislocations. Hand (N Y). 2011; 6:287–94.

9. Guitton TG, Zurakowski D, van Dijk NC, Ring D. Incidence and risk factors for the development of radiographic arthrosis after traumatic elbow injuries. J Hand Surg Am. 2010; 35:1976–80.

10. Monahan PR, Galasko CS. The scapho-capitate fracture syndrome: a mechanism of injury. J Bone Joint Surg Br. 1972; 54:122–4.