月骨与舟状骨经茎突掌侧分离性脱位的一种新型损伤机制：病例报告
A novel injury mechanism of trans-styloid palmar-divergent dislocation of the lunate and scaphoid: a case report.
作者信息
Wang Zhiling, Qu Junjie, Kang Le, Cui Jianqiang, Wang Yanchao, Li Chengli, Xu Lin
机构信息
Department of Orthopaedics, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, China.
出版信息
Front Surg. 2025 Apr 4;12:1526008. doi: 10.3389/fsurg.2025.1526008. eCollection 2025.
BACKGROUND
Palmar-divergent dislocation of the lunate and scaphoid is a rare high-energy trauma with complex injured mechanism. Early diagnosis and surgery are necessary, however, there is no consensus on surgical treatment, as only a few literatures have been reported.
CASE SUMMARY
A 56-year-old man, following a powerful strike to the dorsal side of left wrist and forearm, complained about swelling, tenderness, and limited motion of the left wrist during the physical examination. According to physical and imaging results, this patient was diagnosed with trans-styloid palmar-divergent dislocation of the lunate and scaphoid, as well as radial diaphysis fracture. We performed open reduction, internal fixation with K-wires, ligament reconstruction, and cast immobilization for 6 weeks, followed by early rehabilitation.
CONCLUSION
We firstly described a novel injury mechanism of trans-styloid palmar-divergent dislocation of the lunate and scaphoid based on the classical Mayfield's mechanism, and reviewed suggestions regarding the optimal treatment of palmar-divergent dislocation of the lunate and scaphoid.
背景
月骨和舟骨掌侧分离脱位是一种罕见的高能量创伤，损伤机制复杂。早期诊断和手术是必要的，然而，由于仅有少数文献报道，手术治疗尚无共识。
病例摘要
一名56岁男性，在左腕和前臂背侧受到强力撞击后，体格检查时诉左腕肿胀、压痛及活动受限。根据体格检查和影像学结果，该患者被诊断为经茎突月骨和舟骨掌侧分离脱位以及桡骨干骨折。我们进行了切开复位、克氏针内固定、韧带重建，并石膏固定6周，随后进行早期康复治疗。
结论
我们首先基于经典的梅菲尔德机制描述了一种月骨和舟骨经茎突掌侧分离脱位的新型损伤机制，并回顾了关于月骨和舟骨掌侧分离脱位最佳治疗的建议。
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