Compound dorsal dislocation of lunate with trapezoid fracture

  • Bong-Sung Kim | bong.kim@rwth-aachen.de Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University, Aachen, Germany.
  • Gerrit Grieb Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University, Aachen, Germany.
  • Patrick Rhodius Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University, Aachen, Germany.
  • Arne H. Böcker Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University, Aachen, Germany.
  • Jan-Philipp Stromps Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University, Aachen, Germany.
  • Nils Andreas Krämer Department of Diagnostic and Interventional Radiology, RWTH Aachen University, Aachen, Germany.
  • Norbert Pallua Department of Plastic and Reconstructive Surgery, Hand Surgery - Burn Center, RWTH Aachen University, Aachen, Germany.

Abstract

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 Kwire 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.

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Published
2016-12-13
Section
Case Reports
Keywords:
Lunate dislocation, trapezoid fracture, wrist trauma, closed reduction, scapholunate dissociation.
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How to Cite
Kim, B.-S., Grieb, G., Rhodius, P., Böcker, A. H., Stromps, J.-P., Krämer, N. A., & Pallua, N. (2016). Compound dorsal dislocation of lunate with trapezoid fracture. Clinics and Practice, 6(4). https://doi.org/10.4081/cp.2016.879