Kastanis Grigorios, Velivasakis George, Pantouvaki Anna, Spyrantis Manolis
Department of Orthopaedics, General Hospital of Heraklion-Venizeleio, Crete, Greece.
Department of Physiotherapy, General Hospital of Heraklion-Venizeleio, Crete, Greece.
Case Rep Orthop. 2019 Jul 11;2019:7207856. doi: 10.1155/2019/7207856. eCollection 2019.
Perilunate dislocation and fracture dislocations are rare injuries corresponding to 10% of all carpal injuries. They usually come with high-energy trauma, with associated injuries representing 61%. Volar lunate dislocation or fracture-dislocation accounts for 3% of perilunate injuries. We present a case of a 42-year-old polytrauma male, transmitted to our department 48 hours after a car accident with a trans-scaphoid volar lunate dislocation. During operation, the lunate was displaced volarly to the ulnar side of the wrist, forward to the styloid process of the distal ulna, while the scaphoid fracture appeared at the waist with comminution, and the proximal pole of the scaphoid protruded under the dorsal capsule. Carpal injuries are often missed out in polytrauma patients, and these injuries are underestimated because of the severity of the other visceral or extremity lesions. Untreated or improperly treated, those injuries lead to serious morbidity and loss of function. Therefore, good functional prognosis with decreased percentage of complications can be achieved following early recognition and early open surgical ligamentous complex repair.
月骨周围脱位和骨折脱位是罕见的损伤，占所有腕骨损伤的10%。它们通常伴有高能创伤，相关损伤占61%。掌侧月骨脱位或骨折脱位占月骨周围损伤的3%。我们报告一例42岁的多发伤男性患者，在车祸后48小时被送至我院，诊断为经舟骨掌侧月骨脱位。手术中，月骨向掌侧移位至腕部尺侧，向前移位至尺骨远端茎突，同时舟骨腰部出现粉碎性骨折，舟骨近端在背侧关节囊下突出。多发伤患者常漏诊腕骨损伤，且由于其他内脏或肢体损伤的严重性，这些损伤被低估。未经治疗或治疗不当，这些损伤会导致严重的发病率和功能丧失。因此，早期识别并早期进行开放性手术修复韧带复合体，可获得良好的功能预后并降低并发症发生率。
