Scaphoid Fracture with a Dorsally Dislocated Proximal Fragment as a Variant of Dorsal Perilunate Fracture-Dislocation

Abstract

Perilunate fracture-dislocations of the wrist are very complex. They are now generally described as a spectrum of injury leading to ligament disruption, fracture, or a combination of both. However, classification is difficult partly because of the many subtle variables encountered clinically and the often confusing and conflicting terminology used throughout the literature, but perhaps more. So, these complex injuries are not yet fully understood. Moreover, never has a classification included the scaphoid fractures that are not associated with perilunate dislocations. This paper will describe a more confusing case with a dorsally dislocated proximal fragment of the scaphoid fracture and a minor osteochondral fracture of the dorsal capitate head which has not been previously reported. The author believes this present case to be a variable of dorsal perilunate fracture-dislocations which represents an intermittent stage between the scaphoid fracture and perilunate dislocation stages of a spectral injured type of the wrist. The mechanism of injury and methods of treatment will be analyzed and discussed.