Bilateral osteochondroma of the scaphoid causing scapholunate dissociation: a case report

A case with bilateral scaphoid osteochondroma (exostosis) with scapholunate dissociation. In both the cases a proximal row carpectomy was performed with excellent outcome.     

Acute scaphoid fracture with scapholunate gap

Disruptive forces from wrist trauma are thought to fracture bone or disrupt ligaments. Two cases are presented to demonstrate the simultaneous occurrence of acute scaphoid fracture and scapholunate gap. Recommended treatment in acute cases is open reduction and internal fixation of the fracture and open stabilization of the scaphoid. In chronic cases, we recommend open reduction and internal fixation with bone graft to the scaphoid nonunion combined with fusion of the scaphoid-trapezium-trapezoid joint.     

Avascular necrosis of the scaphoid after three-ligament tenodesis for scapholunate dissociation: case report

An unusual complication after tenodesis for scapholunate instability (Brunelli's technique) is described. More than 1 year after the procedure, a fracture of the scaphoid with collapse was observed. Further examination concluded there was avascular necrosis of the scaphoid. The patient was treated with a proximal row carpectomy.     

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.     

Carpal scaphoid chondroma complicated by fracture: a case report

The carpal scaphoid is an uncommon localization for chondroma. Ten cases have been reported in the literature. We report a new case of right carpal scaphoid chondroma complicated by fracture in a 30 year-old man. The diagnosis was strongly suggested by the computed tomography scan and confirmed at pathology examination of the operative specimen. Treatment consisted in tumor enucleation and a cortico-cancellous graft to fill the gap followed by plaster case immobilization. Clinical and radiological outcome was favorable.     

Bilateral traumatic scapholunate dissociation: Case report

In 1923, Destot described scapholunate dissociation (SLD) which results from disruption of the scapholunate interosseous ligament. Several hypotheses have been proposed to explain SLD, such as traumatic, congenital, ligamentous laxity, and synovial pathology. We are presenting a very rare and challenging case of elderly patient who had traumatic bilateral scapholunate dissociation after a fall, which was managed by ligament reconstruction using bone anchor suture, and kirschner wire fixation. The identification of risk factors for frequent falls among older persons is of paramount importance to prevent further serious injuries.     

Scaphoid and capitate fracture with concurrent scapholunate dissociation

Combined fracture of the scaphoid and capitate bones with concurrent scapholunate dissociation, but without severe dislocation, is a rare lesion which results in significant carpal instability and requires operative treatment. We report a case of this unusual injury and its functional result after 20 months.     

Extensor pollicis longus tendon rupture as a result of scapholunate dissociation: a case report.

A 39-year-old patient was presented with, to our knowledge, the first ever diagnosed case of extensor pollicis longus (EPL) tendon rupture as a result of scapholunate (S-L) dissociation. Arthroscopic findings showed that the dorsal aspect of the S-L ligament was ruptured and severe synovitis was revealed around the S-L joint. Direct observation revealed synovium at the rupture site of the EPL tendon. After careful resection of this synovium, an aperture in the S-L joint was observed. Thus, it was considered that the synovium in the S-L joint was connected to the rupture site of the EPL tendon, passing through the dorsal capsule of the S-L joint. The ruptured EPL tendon was reconstructed with extensor indicis proprius tendon transfer, and S-L dissociation was treated with a bone-retinaculum-bone autograft taken from the third dorsal compartment region.     

Unusual combined scaphoid and lunate fracture of the wrist: a case report

All perilunate fracture-dislocations combine ligament ruptures, bone avulsions, and fractures in a variety of clinical forms. The most frequent is the dorsal trans-scaphoid perilunate dislocation. In rare cases, however, these dislocations also have been associated with capitate fractures, triquetral fractures, or lunate fracture. We report a combined scaphoid and lunate fracture of the wrist that was not associated with perilunate dislocation.     

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.     

Wrist joint tamponade after scaphoid fracture: A case report

A scaphoid fracture was associated with high intraarticular pressure due to hem-arthrosis. Scaphoid and lunate necrosis might be caused by wrist joint tamponade.     

Total volar extrusion of the lunate and scaphoid proximal pole with concurrent scapholunate dissociation

This article describes a case of a 24-year-old man with a total volar extrusion of the lunate and scaphoid proximal pole with concurrent scapholunate dissociation. The viability of the lunate and the proximal pole of the scaphoid are at high risk in this type of injury. Scaphoid nonunion, avascular necrosis of the lunate and proximal pole of the scaphoid, and carpal instability are inevitable unless the blood supply is restored. Thus, proximal row carpectomy at injury may be an acceptable option to avoid these complications and late sequelae, including chronic wrist pain and dysfunction. However, the authors attempted accurate reduction of the extruded bones and internal fixation.Final radiographs and magnetic resonance imaging 12 years postoperatively showed healing without avascular necrosis. Carpal indices involving the scapholunate angle, radiolunate angle, and carpal height ratio were similar in both wrists without evidence of carpal instability or collapse. Range of motion and grip power were 75% and 76%, respectively, compared with those of the uninjured wrist. Clinical scores showed good results, and the patient reported no pain during activities of daily living and was satisfied with his surgical results. Open reduction and internal fixation can be a viable option in this rare pattern of injury.     

Osteoblastoma of the scaphoid: a case report

Osteoblastoma is an uncommon primary bone tumor that rarely is found in the hand or wrist. Recurrent osteoblastomas often have a more aggressive appearance than the original tumor, and differential diagnosis from osteosarcoma is difficult. The pain that can accompany this tumor is debilitating. Therefore, successful treatment requires complete removal of the tumor. The purpose of this report is to present an unusual case of osteoblastoma of the carpal scaphoid. This tumor was treated successfully by curettage and bone grafting. At 1 year postoperatively, the patient presented with a stable, painless wrist with full range of motion.     

Segmental fracture of the scaphoid: report of a rare fracture pattern

Introduction:To the best of our knowledge, there are no reports in the orthopaedic and trauma literature of true segmental fracture of the scaphoid bone. We present such a case with a brief discussion of the morphology and mechanisms of injury of scaphoid fractures and the problems they present, particularly in diagnosis. Case history: A 43-year-old male with polytrauma sustained in a motorcycle road traffic accident was treated at our hospital. His injuries included a fracture initially thought to involve the waist of the scaphoid. Because he had bilateral upper limb injuries, we elected to treat the fracture surgically to facilitate rehabilitation. At the time of surgery, the fracture was noted to be truly segmental, an unsuspected and rare finding. The fracture was internally fixed, with a satisfactory result. Discussion: Scaphoid fracture patterns are generally consistent and predictable, occurring most commonly through the waist of the bone. Mechanism for injury is thought to be hyperextension of the wrist. Comminution, with or without a butterfly fragment, is occasionally seen, as are simultaneous tuberosity fractures. We suggest that the mechanism in this case may have been multiple or secondary trauma, or an effect of loaded rotation. We highlight the need for careful imaging of the scaphoid bone prior to choosing treatment.     

孤立闭合性腕舟骨完全脱位1例

患者,男,40岁,因车祸撞伤左上肢致左前臂腕关节肿胀疼痛、活动受限2d入院。查体:左前臂处有擦痕,肿胀,压痛,左腕关节肿胀明显,掌侧可触及脱位舟骨,腕关节背侧有凹陷感,腕关节屈伸活动明显受限。左腕X线片示:左腕舟骨完全脱位至桡骨远端掌侧(图1a,1b),近极可见细小骨折线。急诊行闭合复位失败后入院,在臂丛麻醉下采用腕背侧入路,经鼻烟窝于腕背部做"S"形切口,切开皮肤、皮下组织,     

Simultaneous fractures of the capitate and hamate in the coronal plane: case report

Fractures of the carpal bones in the coronal plane are encountered rarely and their diagnosis usually is delayed. Coronal hamate fractures are relatively well described but a coronal capitate fracture occurring simultaneously with a coronal hamate fracture is extremely rare. We describe such an injury addressed with fixation of the hamate alone.