Dislocation of the carpal scaphoid associated with median nerve compression: case report.

Dislocation of the carpal scaphoid is a rare injury. A case of delayed diagnosis of scaphoid dislocation necessitating late treatment is described. The scaphoid was displaced anteromedially, causing compression of the median nerve in the carpal canal. Treatment consisted of carpal tunnel decompression and scapho-trapezium trapezoid fusion. Useful wrist motion without significant pain was restored.     

先天性双侧近排腕骨融合一例

患者女,62岁.因右腕部畸形、疼痛、活动受限40 min急诊入院.临床检查:一般情况可,生命体征平稳;右腕部轻度肿胀,呈"锅铲"状畸形,局部有明显的压痛,叩击痛,右腕关节生理功能基本消失,右手各手指感觉、血运正常;无明显的既往病史.     

Unusual coalition of the carpal bones with simian crease: a case report

We present a case of scapholunate coalition with absent fifth metacarpal on one hand, and scapholunate triquetral coalition on the other hand. The patient was asymptomatic, though he was aware of the deformity of the little and ring fingers on the right hand. No treatment was offered as the deformity was not incapacitating and the syndactyly did not interfere with hand function.     

Isolated scaphoid dislocation associated with axial carpal dissociation: an unusual injury report

We present a report of a patient with an isolated scaphoid dislocation associated with a hyperextension and axial loading injury of the carpus required a careful and extensive clinical and radiographic evaluation leading to surgical intervention to reduce and stabilize the scaphoid and to reduce and hold internally the axial carpal injury. Knowledge of the anatomy and the potential injury patterns of the carpus will aid the hand surgeon with injury recognition and proper treatment.     

Isolated volar fracture-dislocation of the scaphoid with acute carpal tunnel syndrome: a case report

Dislocations and fracture-dislocations of the scaphoid are rare injuries. When they occur in a volar direction, they may be complicated by median nerve compression. While volar dislocations and fracture-dislocations of the scaphoid presenting late with median nerve compression have been reported, such injuries presenting with acute median nerve compression have not been reported. We describe a case of volar fracture-dislocation of the proximal half of the scaphoid causing median nerve compression and presenting with acute carpal tunnel syndrome. Urgent open reduction and internal fixation of the scaphoid along with decompression of the median nerve achieved prompt relief of the neurological symptoms.     

Fractures of the carpal bones excluding the scaphoid

Carpal fractures excluding the scaphoid can cause morbidity that is disproportionate to their incidence because they are easily overlooked and are often harbingers of a wider wrist injury. Failure to recognize a more global injury pattern can result in undertreatment and permanent wrist dysfunction. Diagnosis requires a high index of suspicion, familiarity with carpal topography to guide the physical examination, and judicious use of specialized radiographic views and ancillary imaging techniques. Copyright © 2002 by the American Society for Surgery of the Hand     

Dislocation of the scaphoid and lunate bones without fracture: a case report

A patient with a dislocation of both lunate and scaphoid bones is described. The position of the hand at the moment of injury seems to have been dorsiflexion and radial deviation. A mechanism for this injury is proposed. Internal fixation in severe carpal injuries is advised.     

Reconstruction of isolated scaphoid dislocation with carpal dissociation,associated with a carpal anomaly

A case is presented of isolated scaphoid dislocation with carpal dissociation in the presence of a lunato-triquetral coalition. We present the treatment and follow-up of this case. In addition, the literature on scaphoid dislocation and its treatment is reviewed. We emphasize the need to reconstruct the carpal alignment and scapho-lunate linkage.     

Simultaneous fracture of the carpal scaphoid and adjacent bones

Eleven cases of simultaneous fracture of the carpal scaphoid and neighbouring bones are presented. The factors necessary for the occurrence of such injuries are discussed.     

Radiocarpal articular contact characteristics with scaphoid instability

The relative importance of the three major periscaphoid ligament complexes in maintaining the normal radiocarpal articulation was assessed. Pressure-sensitive film recorded the changes in radioscaphoid and radiolunate articular contact that occurred with sequential ligament sectioning in 12 cadaver wrists. Alterations in the radiocarpal articular contact as a result of ligament disruption are evident in the absence of the recognizable static x-ray changes of carpal instability. The scapholunate interosseous ligament is essential in preventing scapholunate diastasis and dorsoradial subluxation of the proximal scaphoid. Rotatory subluxation of the scaphoid occurs when disruption of the scapholunate interosseous ligament is coupled with disruption of either the palmar intracapsular radiocarpal ligaments or the scaphotrapezial ligament complex. These data help explain the development of degenerative arthritis caused by carpal ligamentous instability.     

Avascular necrosis of multiple carpal bones. A case report

A case of a 66-year-old female patient with hyperlipaemia, corticosteroid osteoporosis and chronic obstructive lung disease with avascular necrosis of the proximal row of the carpus and hamate is described. No other sites of avascular bone necrosis were found. A proximal row carpectomy was performed with an excellent outcome.     

Unusual dislocations of the carpal bones (case report)

The author describes 2 unusual injuries in the carpal region, i.e. the dislocation of os scaphoideum and os pisiforme.     

Bilateral bipartite lunate: a case report

A rare case of bilateral bipartite lunate is reported. Radiographs showed that the lunate was divided into palmar and dorsal parts. Computed tomography and magnetic resonance imaging were used to differentiate this variant from lunate fracture.     

Non-union fractures of the scaphoid and carpal bones in children: surgical treatment

Carpal bone fractures in children are rare. This study reports a series of 16 cases: 12 fractures of the scaphoid (11 non-union), two of the trapezium, one (non-union) of the hamatum, and one of the triquetrum. Only three of these fractures (triquetrum, trapezium and hamatum) were seen at an early stage. The non-union cases involving the scaphoid and hamatum were treated by bone graft. The scaphoid fracture seen early and the triquetrum fracture were treated orthopaedically. One trapezium fracture was treated by osteosynthesis with wires, and the other (seen at the defective callus stage) was not treated because of a total absence of symptomatology. All fractures or non-union cases consolidated. After a minimum follow-up of 1 year, all patients except one have regained strength and mobility comparable to that of the contralateral limb, with a near total absence of pain. Only the patient with an articular fracture of the trapezium has lost 30% of strength compared with the uninjured limb.