title: Complex carpal dissociation with open, complete, and divergent trapezium, capitate, and hamate dislocation: a case report.
abstract: We report a patient with a unique complex carpal dissociation involving complete and divergent dislocation of the hamate, capitate, and trapezium with total ligamentous disruption of the distal carpal row and midcarpal joint, associated with a transverse shaft fracture of the fifth metacarpal. The mechanism of injury was a sustained torsional force resulting in a simultaneous distraction and bidirectional dorsopalmar (ulnar)-palmodorsal (radial) crushing force at the carpus.
authors.affiliation: Department of Hand Surgery, Singapore General Hospital, Singapore, Singapore. harveychim@yahoo.com
authors.forename: Harvey
authors.initials: H
authors.lastname: Chim
authors.forename: Andrew K T
authors.initials: AK
authors.lastname: Yam
authors.forename: Andrew Y H
authors.initials: AY
authors.lastname: Chin
authors.forename: Lam Chuan
authors.initials: LC
authors.lastname: Teoh
mesh_terms: D000062:Accidents, Occupational; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D050824:Carpal Joints / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D003646:Debridement; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D004204:Joint Dislocations / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D008875:Middle Aged; D011859:Radiography; D017695:Soft Tissue Injuries / Q000150:complications / Q000601:surgery; D013524:Surgical Flaps