Section 8
Chapter 7,965

Transscaphoid perilunate fracture dislocation and pseudarthrosis of the scaphoid

Engel, A.F.; Keeman, J.N.

Netherlands Journal of Surgery 42(5): 128-130


ISSN/ISBN: 0167-2487
PMID: 2255403
Accession: 007964608

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The results of conservative treatment of a perilunate fracture dislocation were retrospectively studied. In six patients, the treatment consisted of closed reduction and immobilization in a below the elbow cast for 12 to 16 weeks. Five patients had a compromised healing of the scaphoid fracture. The frail vascularization of the scaphoid, extensive ligamentous injury and possible mid-carpal instability in case of perilunate fracture dislocation as well as a non-anatomical reduction of a scaphoid fracture are causative factors in ensuing scaphoid pseudarthrosis. If anatomical reduction of a perilunate fracture dislocation cannot be obtained, open reduction and internal fixation should be considered. This will offer the scaphoid the best chance at fracture healing and will restore the stabilizing function on the mid carpus.

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