Open AccessTwo stage procedure for neglected transscaphoid perilunate dislocation
Author(s) -
Hitesh Lal,
Vivek Jangira,
Rahul Kakran,
Deepak Mittal
Publication year - 2012
Publication title -
indian journal of orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.434
H-Index - 33
eISSN - 1998-3727
pISSN - 0019-5413
DOI - 10.4103/0019-5413.90427
Subject(s) - medicine , lunate , wrist , internal fixation , wrist pain , surgery , carpal bones , reduction (mathematics) , ulnar deviation , fixation (population genetics) , range of motion , orthopedic surgery , population , geometry , mathematics , environmental health
We report a two-staged surgical procedure for neglected 3 month old volar transscaphoid, transcapitate perilunate fracture dislocation wrist in an 18 year old right handed male student. The lunate with proximal scaphoid and proximal capitate maintained its articulation with distal end radius while the rest of carpal bones had dislocated volarly. In the first stage, bilateral uniplanar wrist distractor was applied with the aim of stretching soft tissue. In the next stage open reduction and internal fixation was done by a combined volar and dorsal approach augmented by pronator quadratus flap. At 3 years followup the patient was pain free and had a full range of supination pronation of the forearms and radial and ulnar deviation of wrist with 10° dorsiflexion deficit.