Abstract
This report is of a 32 year old man who presented with complains of pain, swelling and deformity of right wrist of four weeks duration. He gave history of road traffic accident four weeks back leading to injury to right wrist; Preoperative radiographs and C.T. scan images were suggestive of trans-scaphoid dislocation of the proximal row of wrist. A volar and dorsal approach were used to reduce this complex dislocation but was not successful. Wrist arthodesis was performed after doing proximal row carpectomy. One year follow-up of the patient showed fair result with grip strength of 85% to contralateral side and modified Mayo wrist score of 65 at one year.
Highlights
Dislocation of wrist is severe injury resulting from extreme position of the wrist
Rare patterns involve the dislocation of the scaphoid [2] pisiform [3-6] triquetrum [7] trapezium [8] trapezoid [9] capitate [10] hammate [11] and scapholunate[12] as a unit
A thirty two year old right hand dominated male patient presented with complaints of swelling, pain on movements, limited movements, and loss of grip strength of right wrist of four weeks duration
Summary
Dislocation of wrist is severe injury resulting from extreme position of the wrist. Trans-scaphoid perilunate dislocation is the most common dislocation pattern.[1]. The closest injury pattern described is transverse fractures of the scaphoid, triquetrum, lunate, and pisiform with volar dislocation to the mid-forearm [13]. A thirty two year old right hand dominated male patient presented with complaints of swelling, pain on movements, limited movements, and loss of grip strength of right wrist of four weeks duration. The x-rays, done four weeks after the injury, were suggestive of fracture scaphoid and dislocation of the proximal row of carpals. The patient was advised proximal row carpectomy or wrist arthodesis if reduction of carpals failed since the injury was old. The proximal pole of scaphoid, lunate, triquetrum and pisiform were found to be dislocated as a unit (Figure 3). Dislocated proximal row was excised (Figure 4) and wrist arthodesis was performed with the wrist in neutral position. The patient showed fair result with grip strength of 85% to contralateral side and modified Mayo wrist score [14] of 65 at one year
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