Compound Dorsal Dislocation of Lunate with Trapezoid Fracture.
We report about a dorsal dislocation of the lunate accompanied by a trapezoid fracture in a 41-year old male patient after a motorcycle accident. The lunate dislocation with no dorsal or volar intercalated segment instability (DISI, VISI) was diagnosed by x-ray whereas the trapezoid fracture was only diagnosable by computed tomography. A closed reduction and internal fixation of the lunate by two Kirschner wires was performed, the trapezoid fracture was conservatively treated. Surgery was followed by immobilization, intense physiotherapy and close follow-up. Even though complaints such as swelling and pain subsided during the course of rehabilitation, partial loss of strength and range of motion remained even after 16 months. In conclusion, a conservative treatment of trapezoid fractures seems to be sufficient in most cases. Closed reduction with K-wire fixation led to an overall satisfactory result in our case. For dorsal lunate dislocations in general, open reduction should be performed when close reduction is unsuccessful or DISI/VISI are observed in radiographs after attempted close reduction.
Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University , Aachen, Germany.
Bong-Sung
BS
Kim
Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University , Aachen, Germany.
Gerrit
G
Grieb
Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University , Aachen, Germany.
Patrick
P
Rhodius
Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University , Aachen, Germany.
Arne H
AH
Böcker
Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University , Aachen, Germany.
Jan-Philipp
JP
Stromps
Department of Diagnostic and Interventional Radiology, RWTH Aachen University , Aachen, Germany.
Nils Andreas
NA
Krämer
Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University , Aachen, Germany.
Norbert
N
Pallua
Lunate dislocation; closed reduction; scapholunate dissociation; trapezoid fracture; wrist trauma