Triple jeopardy: transscaphoid, transcapitate, transtriquetral, perilunate fracture dislocation

Bhavuk Garg, Tarun Goyal, Prakash P Kotwal, Bhavuk Garg, Tarun Goyal, Prakash P Kotwal

Abstract

Carpal injuries are frequently underdiagnosed and underreported injuries of the hand. Scapholunate perilunate dissociation is the most common perilunate instability pattern seen in clinical practice. Transscaphoid, transtriquetral, transcapitate dislocation with a volar intercalated segment instability pattern is a very rare pattern of carpal injury. We describe a case with this unique pattern of injury, explaining its mechanism and treatment. Good outcome can be achieved in these injuries following open reduction and internal fixation with ligamentous repair.

Figures

Fig. 1
Fig. 1
Preoperative radiograph showing fracture of the scaphoid, capitate, and triquetrum, with perilunate dislocation. The radiolunate angle is marked in the figure
Fig. 2
Fig. 2
Intraoperative radiograph showing reduction and screw fixation of the scaphoid and capitate. The capitate appears to be aligned with the lunate on the lateral view
Fig. 3
Fig. 3
Radiographs at follow-up showing optimally reduced fractures of the scaphoid and capitate and reduction of the perilunate dislocation

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