Abstract

Trans-scaphoid perilunate fracture-dislocation is a severe injury caused by a high-energy trauma. Closed or open reduction of the perilunate dislocation and internal fixation of the scaphoid are required. A dorsal approach to the perilunate dislocation allows for a good exposure of the carpal bones and an adequate control of the reduction. Internal fixation of the scaphoid can be done through the same dorsal approach or by a separate volar incision. Screw fixation of the scaphoid is recommended when technically feasible. A delayed treatment is frequent as a result of misinterpretation of the radiographs. Radiocarpal and intercarpal arthrosis (SLAC and SNAC wrist) can be late complications of a trans-scaphoid perilunate dislocation due to residual carpal instability or scaphoid nonunion.

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