Citation, DOI, disclosures and article data
Citation:
Jones J, Knipe H, Greater arc injury. Reference article, Radiopaedia.org (Accessed on 07 May 2024) https://doi.org/10.53347/rID-18595
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Henry Knipe's current disclosures
Greater arc injuries are perilunate fracture-dislocations that are twice as common as lesser arc injuries, which are purely ligamentous perilunate dislocations 1. They account for ~5% of wrist fractures 1. The associated fractures may be trans-radial styloid, trans-scaphoid (most common 4), trans-capitate, trans-triquetrum, trans-ulnar styloid, or a combination thereof 1-3. They can be complicated by neurovascular injury, particularly of the median nerve 4.
Mechanism
These are most commonly the result of high-velocity trauma (e.g. falls, motor vehicle accidents) 4.
Differential diagnosis
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1. Lasanianos N & Giannoudis P. Greater Arc Injuries: Perilunate Fracture-Dislocations. Trauma and Orthopaedic Classifications. 2014;:131-4. doi:10.1007/978-1-4471-6572-9_28
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2. Shivanna D, Manjunath D, Amaravathi R. Greater Arch Injuries. J Hand Microsurg. 2014;6(2):69-73. doi:10.1007/s12593-014-0143-5 - Pubmed
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3. Kinghorn A, Finlayson G, Faulkner A, Riley N. Perilunate Injuries: Current Aspects of Management. Injury. 2021;52(10):2760-7. doi:10.1016/j.injury.2021.09.012 - Pubmed
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4. Sabat D, Dabas V, Suri T, Wangchuk T, Sural S, Dhal A. Trans-Scaphoid Transcapitate Transhamate Fracture of the Wrist: Case Report. J Hand Surg Am. 2010;35(7):1093-6. doi:10.1016/j.jhsa.2010.04.023 - Pubmed
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