Author(s): Jared B Hinton, Vanessa C Heck, Benjamin E Heck, Logan Van Poucke, Ravij Mehta and Bruce E Heck

Abstract: Perilunate fracture-dislocations are rare but severe wrist injuries that typically result from high-energy trauma. These injuries can be easily missed and may lead to long-term dysfunction if not promptly recognized and treated. Here, we present a case of a nineteen-year-old competitive dirt bike rider who sustained a trans-scaphoid perilunate fracture-dislocation after a fall on an outstretched hand. He arrived with severe pain, deformity, and numbness in the distribution of the median nerve. Imaging confirmed a trans-scaphoid perilunate fracture-dislocation with additional fractures of the triquetrum, capitate, and radial styloid. Closed reduction was performed in the emergency department, followed by open surgical fixation using a headless compression screw and multiple pins to restore carpal alignment. Early postoperative radiographs showed changes consistent with decreased vascularity of the proximal scaphoid, though the patient remained asymptomatic. At eighteen months after surgery, he reported no pain and had returned to full activity. This case highlights the importance of meticulous recognition, surgical management, and the need for long term follow-up regarding this complex injury associated with many complications.

DOI: 10.22271/27080056.2025.v7.i2c.159

Pages: 158-162 | Views: 111 | Downloads: 38

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