First-stage scapholunate fusion for the treatment of a chronic lunate dislocation: A case report

Medicine (Baltimore). 2019 Jul;98(28):e16453. doi: 10.1097/MD.0000000000016453.

Abstract

Rationale: Lunate dislocation is a rare injury to the wrist caused by high-energy trauma, and poor prognosis is often associated with missed initial diagnosis. To date, there is no consensus regarding an effective treatment plan for such cases.

Patient concerns: Here, we describe the case of a 36-year-old man who presented with lunate dislocation following a delay in diagnosis of over 7 weeks, and further illuminate its diagnosis and treatment.

Diagnosis: The diagnosis of chronic lunate dislocation was rendered.

Interventions: The patient was treated using reduction via the dorsal approach brachial plexus anesthesia. After the reduction, a headless compression screw fixation was performed for first-stage scapholunate fusion, and Kirschner wire fixation of the lunate-triquetrum-hamate was used to stabilize the distal and proximal carpal rows.

Outcomes: The patient was followed up for 1 year and showed wrist function recovered well; radiographic examination showed no lunate dislocation and successful scapholunate bony fusion. A satisfactory outcome was achieved.

Lessons: The case study presented here provide evidence that performing an effective first-stage scapholunate fusion is recommended to achieve better therapeutic outcomes for a chronic lunate dislocation. Furthermore, this approach led to a good long-term clinical outcome in our case.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chronic Disease
  • Delayed Diagnosis
  • Humans
  • Internal Fixators
  • Joint Dislocations / diagnosis
  • Joint Dislocations / surgery*
  • Lunate Bone / surgery*
  • Male
  • Scaphoid Bone / surgery*
  • Wrist Injuries / diagnosis
  • Wrist Injuries / surgery*