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Trans-scaphoid perilunate dislocation

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Wrist trauma

Patient Data

Age: 20 years
Gender: Male

Fracture of the scaphoid with dorsal dislocation of the carpus relative to the lunate.

CT confirms the findings seen on the plain films, and better delineates the multiple small fragments at the scaphoid fracture. Note how the radiolunate joint is a little widened but remains aligned. 

Annotated image

Capitate (C, blue) is dislocated dorsal to the lunate (L, yellow). The proximal pole of the scaphoid (PP) has remained aligned with the lunate, whereas the distal pole (DP) has followed the capitate dorsally.  The lunate and the distal radius (green) remain normally aligned. 

Case Discussion

Typical appearances of a trans-scaphoid perilunate dislocation.

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