TRAUMATIC SCAPHOLUNATE DISSOCIATION - CASE REPORT

Authors

  • D. POPESCU University of Medicine and Pharmacy"Grigore T. Popa"- Iași
  • S. ALBETAR Emergency Hospital "Sf. Spiridon"- Iași
  • O. ALEXA University of Medicine and Pharmacy"Grigore T. Popa"- Iași

Abstract

Perilunate injuries occur after an impact trauma to the wrist. The recognition of these lesions and immediate treatment are the two essential conditions to ensure the best possible outcome. The first therapeutic step is the restoration of anatomical joint relationships of the carpus followed by percutaneous pinning or internal fixation required for maintaining the congruence this segment. Despite correct diagnosis and approach in these cases the prognosis is often encumbered by decreased range of motion, loss of grip strength and finally the onset of osteoarthritis. Scapholunate dissociation is the most frequent pattern of carpal instability. We report the case of a 53-year-old woman diagnosed with scapholunate dissociation resulting from an injury caused by fall from the same level on the outstretched right hand (dominant hand). Surgery was performed 48 hours post-injury and consisted in external reduction followed after the restoration of the anatomical joint relationships in the right wrist by percutaneous pinning. Postoperatively the wrist was immobilized in brachipalmar cast for 8 weeks and arthrosynthesis pins were removed. The patient was reassessed at 6 months postoperatively by clinical and radiological evaluations and the functional outcome was good.

Author Biographies

  • D. POPESCU, University of Medicine and Pharmacy"Grigore T. Popa"- Iași

    Faculty of Medicine
    Department of Surgery

  • S. ALBETAR, Emergency Hospital "Sf. Spiridon"- Iași

    Orthopaedic and Traumatology Clinic

  • O. ALEXA, University of Medicine and Pharmacy"Grigore T. Popa"- Iași

    Faculty of Medicine
    Department of Surgery

References

1. Voorhees DR, Daffner RH, Nunley JA, Gilula LA. Carpal ligamentous disruptions and negative ulnar variance. Skeletal Radiol 1985; 13(4): 257-262.
2. Ritt MJ, Bishop AT, Berger R.A, Linscheid RL, Berglund LJ, An KN. Lunotriquetral ligament prop-erties: a comparison of three anatomic subregions. J. Hand Surg 1998; 23A: 425-431.
3. Berger RA, Blair WF, Crowninshied RD, Flatt AE. The scapholunate ligament. J Hand Surg 1982; 7A: 87-91.
4. Berger RA, Kauer JM, Landsmeer JM. Radioscapholunate ligament: a gross anatomic and histologic study of fetal and adult wrists. J. Hand Surg 1991; 16A: 350-355.
5. Michael E, Raemisch MD, Mitchell B, Rotman MD. Palmar Dislocation of the Scaphoid and Lunate as a Unit. Orthobluejournal 2004; 27:1199-1201.
6. Mayfield JK. Patterns of injury to carpal ligaments: a spectrum. Clin. Orthop 1984; 187: 36-42.
7. Herzberg G, Comtet JJ, Linscheid RL, Amadio PC, Cooney WP, Stalder J. Perilunate dislocations and fracture-dislocations: A multicenter study. J Hand Surg 1993; 18: 768-779.
8. Sotereanos DG, Mitsionis GJ, Giannakopoulos PN, Tomaino MM, Herndon JH. Perilunate disloca-tion and fracture dislocation: a critical analysis of the volar-dorsal approach. J. Hand Surg. 1997; 22(1): 49-56.
9. Whipple TL. The role of arthroscopy in the treatment of scapholunate instability. Hand Clin 1995; 11: 37-40.
10. Hildebrand KA, Ross DC, Patterson SD, Roth JH, MacDermid JC, King GJ. Dorsal perilunate dislo-cations and fracture-dislocations: questionnaire, clinical, and radiographicevaluation. J Hand Surg Am 2000; 25(6): 1069-1079.

Additional Files

Published

2015-06-30

Issue

Vol. 119 No. 2 (2015): The Medical-Surgical Journal

Section

SURGERY

License

COPYRIGHT 
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.

COPYRIGHT TRANSFER FORM FOR 

REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /

THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI

We, the undersigned authors of the manuscript entitled

_____________________________________________________________________________________

_____________________________________________________________________________________

warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.

  1. we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
  2. the manuscript does not break the intellectual property rights of any other person.
  3. we have read the submitted version of the manuscript and we are fully responsible for the content.

Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):

  1. ______________________________/_________________________
  2. ______________________________/_________________________
  3. ______________________________/_________________________

N.B.  All the authors must sign this form