Presentation
Blunt trauma, high-velocity impact, motorbike incident. Limited wrist mobility, pain and swelling.
Patient Data
There is complete proximal carpal row fracture-dislocation with loss of the normal proximal carpal row and foreshortening. There is rotation and volar displacement of the scaphoid and lunate bones, and rotation and dorsal displacement of the triquetrum. There are multiple bone fragments proximal to the trapezium and trapezoid bones. There are tiny bone fragments adjacent to the scaphoid and radial styloid.
There is a Bennett's fracture of the right first metacarpal.
The wrist and hand appear otherwise normal on X-rays.
There is an excellent reduction and alignment with the restoration of the proximal carpal row, following open reduction and internal fixation (ORIF). There are 2 Kirschner wires fixating the medial and lateral wrist. A lagging screw is present within the lunate bone. Persistent bone fragments are present adjacent to the truncated radial styloid. A persistent Bennett's fracture is present. A backslab is noted.
Case Discussion
A high-velocity incident and its impact on the right wrist caused a significant proximal carpal row fracture-dislocation as demonstrated. The post-operative views demonstrate the reduction and restoration of the proximal carpal row. The Bennett's fracture is still to be surgically managed.
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