A Clinical Study of Carpal Scaphoid Fracture and Perilunat Dislocation

Kang, Eung Shick; Hahn, Soo Bong; Kim, Dong Wook

Abstract

The wrist consists of a complex structure, including 8 tiny carpal bones and their adjoining soft tissue. Recently the number of injuries of carpal joint is on the increase by accident in leisure or by industrial accident. Carpal bone fracture or dislocation is often mistakably identified as a sprain, which is liable to lead its opportune time to care. So, we analyzed 39 cases to which long-term follow-up was available, among 44 cases which were treated at the department of orthopedic surgery, Yonsei University medical college. The results were as follows; l. Of all 44 cases, 42 were males, and males in 30, 40 decades numbered 32 cases, forming 73 % of all. 2. Of 29 scaphoid fractures, 22 cases were mid 1/3 fractures, and of 15 perilunate dislocation, 10 cases were dorsal transscaphoid perilunate dislocations. 3. Among 39 cases which long-term follow-up was available in the classification by Soto-Hall, 18 cases were acute, in 21 cases treatment was started beyond 2 weeks later after injury. 4. The more delayed diagnosis, the longer period needed bone union for scaphoid fracture. 5. All scaphoid fractures including transscaphoid perilunate dislocation, showed a union rate of 94.3%, and were complicated by 2 non-unions, 3 avascular necrosis, 1 osteoarthritis and one case accompanied an incomplete median nerve injury. So, initial careful evaluation is needed to good prognosis of scaphoid fracture.