Abstract
There is a fracture through the waist of the scaphoid associated with a perilunate dislocation consistent with a trans-scaphoid perilunate dislocation. This has been treated by open reduction and fixation with Kirschner wires across the lunotriquetral interval and a Herbert compression screw across the trans-scaphoid fracture. These are extremely important injuries, 25% are missed at initial presentation and may lead to serious complications. They can occur following high-energy trauma, such as road traffic accidents or sporting injuries, causing hyperextension of the wrist. 26% of injuries are associated with polytrauma. Perilunate dislocations occur in a sequence of events involving either ligament and/or bony disruption. This injury pattern typically starts on the radial side and destabilizes either through the body of the scaphoid or through the scapholunate interval. Mayfield et al described the ligamentous sequence of events:
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