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Case Reports
. 2025 Apr 4:12:1526008.
doi: 10.3389/fsurg.2025.1526008. eCollection 2025.

A novel injury mechanism of trans-styloid palmar-divergent dislocation of the lunate and scaphoid: a case report

Zhiling Wang  1 , Junjie Qu  1 , Le Kang  1 , Jianqiang Cui  1 , Yanchao Wang  1 , Chengli Li  1 , Lin Xu  1
Affiliations
Case Reports

A novel injury mechanism of trans-styloid palmar-divergent dislocation of the lunate and scaphoid: a case report

Zhiling Wang et al. Front Surg. .

Abstract

Background: Palmar-divergent dislocation of the lunate and scaphoid is a rare high-energy trauma with complex injured mechanism. Early diagnosis and surgery are necessary, however, there is no consensus on surgical treatment, as only a few literatures have been reported.

Case summary: A 56-year-old man, following a powerful strike to the dorsal side of left wrist and forearm, complained about swelling, tenderness, and limited motion of the left wrist during the physical examination. According to physical and imaging results, this patient was diagnosed with trans-styloid palmar-divergent dislocation of the lunate and scaphoid, as well as radial diaphysis fracture. We performed open reduction, internal fixation with K-wires, ligament reconstruction, and cast immobilization for 6 weeks, followed by early rehabilitation.

Conclusion: We firstly described a novel injury mechanism of trans-styloid palmar-divergent dislocation of the lunate and scaphoid based on the classical Mayfield's mechanism, and reviewed suggestions regarding the optimal treatment of palmar-divergent dislocation of the lunate and scaphoid.

Keywords: ORIF; lunate dislocation; palmar-divergent injury; scaphoid dislocation; scapholunate dissociation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Pre-operative radiography nnshowed the injured left forearm. Lateral (A) and anteroposterior (B) radiographs of the left forearm showed dislocation of lunate and scaphoid as well as multiple radial fractures.
Figure 2
Figure 2
Pre-operative CT of injured left forearm. Coronal plane (A), sagittal plane (B) and transverse plane (C) of CT imaging showed dislocation and separation of lunate and scaphoid as well as multiple fracture. 3D reconstruction results (D–F) showed injury in details.
Figure 3
Figure 3
Intraoperative photos. (A) Median nerve exposure and decompression. (B) Scaphoid dislocation and disappeared lunate. (C) Isolated lunate in intermuscular septum.
Figure 4
Figure 4
Post-operative radiographs. Anteroposterior radiographs at 3rd day (A,B) and at 6th week (C,D).
See this image and copyright information in PMC

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