Introduction

Abstract

Carpal dislocations can be divided into five separate groups: perilunate, radiocarpal, axial, carpometacarpal, and isolated carpal bone dislocations. The most frequent traumatic carpal dislocations are perilunate dislocations or fracture dislocations.

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Carpal dislocations can be divided into five separate groups: perilunate, radiocarpal, axial, carpometacarpal, and isolated carpal bone dislocations. The most frequent traumatic carpal dislocations are perilunate dislocations or fracture-dislocations. Less common are the radiocarpal, axial, and carpometacarpal dislocations, while isolated pure carpal bone dislocations are the most unusual of wrist injuries. They share many common features: all are rare injuries, most often occurring from high-energy trauma, they are usually seen in young males between their second and fourth decades of life, and they could all be initially missed or underestimated.

Rarely is a wrist surgeon fortunate or unfortunate enough (depends on the perspective), to come across an injured patient who suffers from almost all of the above dislocations or fracture-dislocations simultaneously (Fig. 1.1a–k).

Fig. 1.1

The admitted hand (a); the initial X-rays (b, c); the distraction view (d); volar approach, the volarly dislocated capitate and lunate (e); the proximal scaphoid remained volarly dislocated after the reduction of lunocapitate complex (PS Proximal scaphoid) (f); dorsal approach, absence of bones (H Hamate, DS Distal scaphoid, R Radius) (g); dorsal approach, comminution of the volar radial rim (h); dorsal approach, fracture of the dorsal part of the lunate (asterisk) (i); postoperative X-rays (j, k)