Trans-scaphoid perilunate fracture dislocation

Case contributed by Frank Gaillard
Diagnosis certain


Drunk. Fell off balcony 6m.

Patient Data

Age: 20 years
Gender: Male

Right wrist x-rays


Trans-scaphoid perilunate fracture dislocation. Small bony fragment adjacent to the ulnar styloid seen only one view may represent avulsion injury of the TFCC. Incidental radial beak.

CT right wrist


A transverse fracture through the waist of the scaphoid is mildly displaced. Multiple small osseous fragments are seen within both the dorsal and palmar aspect of the intercarpal joint. The previously demonstrated trans-scaphoid perilunate dislocation has been reduced.

A small osseous fragment overlies the dorsal aspect of the ulnar side of the proximal carpal row, and may represent an avulsion fracture from the triquetrum. A tiny bony fragment is seen at the tip of the ulnar styloid process, consistent with an avulsion fracture.

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