Established non-union of an operatively managed trans-scaphoid perilunate fracture dislocation progressing to spontaneous union

• Published in: Journal of orthopaedics and traumatology Vol. 12; no. 3; pp. 159 - 162
• Main Authors: Divecha, Hiren M., Clarke, Jon V., Barnes, Steven J.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2011; Springer Nature B.V
• Subjects: Case Report; Conservative Orthopedics; Fracture Healing; Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; Humans; Joint Dislocations - diagnostic imaging; Joint Dislocations - surgery; Lunate Bone - diagnostic imaging; Lunate Bone - injuries; Lunate Bone - surgery; Male; Medicine; Medicine & Public Health; Orthopedics; Radiography; Remission, Spontaneous; Reoperation; Rheumatology; Scaphoid Bone - diagnostic imaging; Scaphoid Bone - injuries; Scaphoid Bone - surgery; Sports Medicine; Surgical Orthopedics; Time Factors; Traumatic Surgery; Young Adult; Trans-scaphoid perilunate fracture dislocation; Spontaneous union; Non-union
• ISSN: 1590-9921; 1590-9999
• DOI: 10.1007/s10195-011-0143-1

Perilunate dislocations and fracture dislocations represent uncommon and unusual injuries that are often missed at initial presentation and diagnosed late in up to 25% of cases. Prompt open reduction, carpal stabilisation and ligamentous repair is required to reduce the risk of complications. We report a case of an established scaphoid non-union in an operatively managed perilunate fracture dislocation that spontaneously united almost 2 years after the initial injury, just before a planned revision scaphoid fixation with bone grafting. This case highlights the importance of initial clinical assessment together with appropriate radiographs and follow-up of these injuries post-operatively, especially when complications such as non-union arise.