Dissociated Dislocation of the Lunate and Carpal Bones: Case Report

Purpose: Fracture-dislocations of the carp us are unusual injuries, which have been reported with different and complex anatomical patterns. Many classifications have been proposed to diagnose and make the choice of treatment easier. We report a case of dissociated fracture-dislocation of the lunate and carpal bones whose pathogenesis and X-rays seem to be peculiar and unable to be classified. Diagnosis and Treatment: We are presenting a case of a 33-years-old man, who had a high-energy trauma and suffered a “Transradial fracture-dislocation of the navicular and the distal row of carpus and an ipsilateral volar and ulnar luno-triquetral dislocation.” After a failed closed reduction, the patient was taken to the operative room, in loco-regional anesthesia, for open reduction, ligaments repair and fixation with K-wires. The wrist was immobilized in a short arm cast. The K-wires and the cast were removed six weeks later. Results: Full range of motion was recovered after six months. At 1-year follow-up, the Mayo-score was 90/100 and the patient returned to his work as craftsman. Conclusion: For a correct diagnosis and treatment of this kind of injuries, ligamentous disruption must be considered. In the presented case, prompt open reduction and ligamentous repair, followed by internal fixation and application of a cast, yielded a good short-term outcome.