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As palmar-divergent dislocation of the scaphoid and lunate is rare, its optimal treatment remains unclear.
We describe a patient with palmar-divergent dislocation of the scaphoid and lunate.
The patient described here is therefore the seventh with palmar-divergent dislocation of the scaphoid and lunate.
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.
Radiography of the wrist revealed palmar-divergent dislocation of the scaphoid and lunate (Fig. 1) but with no neurovascular disturbance in the hand.
To our knowledge, this is the first report in which interosseous ligaments were sutured by open surgery for divergent dislocation of the scaphoid and lunate.
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The low incidence of avascular necrosis of the scaphoid in partial scaphoid dislocation is probably due to the remaining (distal) scaphotrapezial ligaments, providing sufficient blood supply [17].
There will be no difference in terms of return to previous activity level between patients suffering an acute complete fracture of the mid third of the scaphoid bone, without any dislocation or comminution visible on the CT-scan who are treated surgically with cannulated screw fixation and patients treated non-operatively with short arm cast immobilization.
(g) Radiological healing (h) Complication rate Those patients suffering an acute complete fracture of the mid third of the scaphoid bone without any dislocation or comminution visible on the CT-scan who are treated surgically with cannulated screw fixation will return to their previous activity level sooner than patients treated non-operatively with short arm cast immobilization.
Open image in new window Fig. 1 Preoperative radiograph showing fracture of the scaphoid, capitate, and triquetrum, with perilunate dislocation.
Open image in new window Fig. 3 Radiographs at follow-up showing optimally reduced fractures of the scaphoid and capitate and reduction of the perilunate dislocation.
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