title: Palmar-divergent dislocation of the scaphoid and the lunate.
abstract: We describe a patient with palmar-divergent dislocation of the scaphoid and lunate. After successful closed reduction, the scapholunate and lunotriquetral ligaments were sutured through the dorsal approach, and the anterior capsule was sutured through the palmar approach. The scapholunate and lunotriquetral joints were fixed with Kirschner wires for 7 weeks. At the 1-year follow-up, magnetic resonance imaging showed no evidence of avascular necrosis of the scaphoid or lunate, and radiographs showed no evidence of the dorsal and volar intercalated segment instability patterns associated with carpal instability. However, flexion of the scaphoid and a break in Gilula's line remained. To our knowledge, this is the first report showing treatment of palmar-divergent dislocation of the scaphoid and lunate by suturing the carpal interosseous ligaments.
authors.affiliation: Department of Orthopaedic Surgery, Gifu Prefectural General Medical Center, Gifu, Japan. rbyshingo@yahoo.co.jp
authors.forename: Shingo
authors.initials: S
authors.lastname: Komura
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yokoi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Suzuki
mesh_terms: D006230:Hand Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D011859:Radiography; D020127:Recovery of Function; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D013536:Suture Techniques