Abstract

Abstract:Abnormal subluxation of the carpal scaphoid may be due to minor trauma causing rupture of the scaphoid lunate ligament or major trauma causing perilunar dislocation with residual carpal scaphoid hypermobility that allows the capitate to spread the scaphoid and lunate. The condition is frequently missed by the physician treating the patient initially. The diagnosis can be made by observation of a triangular space between the scaphoid and lunate on the supination anteroposterior roentgenogram. The authors present three patients, one of whom had a severe wrist injury; the second had a mild wrist-hand injury; and the third had a direct blow forcing the wrist into flexion. All three patients were treated by open operation and internal fixation with pins between scaphoid and lunate and scaphoid and capitate. All had moderate limitation of motion but useful wrist with minimal pain. Avascular necrosis of the carpal scaphoid did not occur in spite of open operation.