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Case Reports
. 2016 Apr-Jun;6(2):50-52.
doi: 10.13107/jocr.2250-0685.430.

Novel Presentation of Uncommon Wrist Injury: Simultaneous Lunate and Perilunate Fracture Dislocation (scapho-capitate Syndrome) of Both Wrists

Anil K Bhat  1 , Nishanth A  1 , Ashwath Acharya  1 , Yogesh Kumar  2
Affiliations
Case Reports

Novel Presentation of Uncommon Wrist Injury: Simultaneous Lunate and Perilunate Fracture Dislocation (scapho-capitate Syndrome) of Both Wrists

Anil K Bhat et al. J Orthop Case Rep. 2016 Apr-Jun.

Abstract

Introduction: Perilunate and lunate dislocations are uncommon high energy injuries and have extensive soft tissue, cartilaginous and bony damage. The most common pattern is trans-scaphoid perilunate fracture dislocation which constitutes approximately 50% of these injuries. Unusual injury pattern like Scaphocapitate syndrome can occur with fracture through scaphoid waist and capitate that rotates the proximal capitate 180° so that its proximal articular surface points distally. With this case report, we would like to present a novel presentation of an uncommon wrist injury.

Case report: We present a case of simultaneous lunate dislocation in one wrist and perilunate fracture dislocation (Scapho- capitate syndrome) in the contralateral wrist which occurred simultaneously in a young male following a two wheeler accident. The injury was missed initially at the primary treating centre. Upon diagnosis, the patient underwent open reduction and internal fixation along with ligament repair. The patient was subsequently followed up for a period of four years and was found to have very good clinical and radiological outcome.

Conclusion: These injuries occurring simultaneously in contralateral wrists are exceptionally rare and unusual as the mechanisms of injury are different. These are high velocity injuries and are often missed, especially in presence of other major injuries. These high energy injuries need accurate diagnosis, early and aggressive treatment in order to prevent complications.

Keywords: perilunate dislocation; scapho-capitate syndrome; trans-scaphoid perilunate fracture dislocation.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Left wrist Radiograph and CT images showing volar lunate dislocation (’Spilled tea cup’ sign).
Figure 2
Figure 2
Radiograph and CT images of right wrist showing Scapho-capitate syndrome.
Figure 3
Figure 3
Intra-operative images showing volar lunate dislocation in the left wrist and dorsal Perilunate dislocation and fracture of capitate
Figure 4
Figure 4
Post-operative radiographs of left and right wrists–Postero-anterior views.
Figure 5
Figure 5
Post-operative radiographs of left and right wrists - lateral views.
Figure 6
Figure 6
Four years follow up radiographs- Postero-anteriorviews.
Figure 7
Figure 7
Four years follow up radiographs of both wrists- lateral views.
See this image and copyright information in PMC

References

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