Presentation
Fall from bicycle.
Patient Data
There is a trans-scaphoid perilunate fracture-dislocation. Aside from the lunate the other carpal bones are displaced radially and dorsally.
Multiple fracture fragments are noted. The scaphoid is fractured at the waist.
There is a trans-scaphoid perilunate fracture/dislocation of the left wrist.
The scaphoid is fractured through its waist and the distal pole and the rest of the carpal bones are displaced dorsally and radially relative to the lunate. The lunate has a slight volar tilt.
The radial styloid is fractured (chauffeur fracture) and there are bony fragments lateral to it.
The tip of the ulnar styloid is also fractured.
Case Discussion
Trans-scaphoid perilunate fracture-dislocations are serious and severe injuries, most commonly occurring in the context of high-energy trauma. They may be overlooked initially (both clinically and radiologically) because these patients often have more serious abdominal, thoracic and neurological injuries.