Trans-scaphoid and trans-capitate perilunate fracture-dislocation of the wrist with concomitant ipsilateral fractures: a case report

All perilunate fracture-dislocations combine bone avulsions, ligament disruption and fractures in different forms. The most frequent pattern is the dorsal transscaphoid perilunate fracture-dislocation. The reported risk of missed initial diagnosis in perilunate dislocations is as high as 20%. Concerning pathomechanics of the perilunate fracture-dislocation, it should be noted that most dorsal injuries usually result from a fall on the outstretched hand or motor vehicle accidents although other mechanisms are also mentioned. We describe here a case of dorsal trans-scaphoid trans-capitate perilunate fracture-dislocation together with posterior olecranon fracture-dislocation of the left upper extremity. To the best of the authors' knowledge, such a case with this concomitant elbow fracture-dislocation has not been previously reported in the literature

Fenton syndrome in an adolescent

Scapho-capitate fracture [Fenton syndrome] is a rare lesion and is even less well-documented in adolescents. The most frequent mechanism is possible forced extension and hyperextension of the wrist. We report a case of 15 years old boy with hyperextension injury to the wrist. The true diagnosis was made 2 weeks later. Treatment involved open reduction and internal fixation with K-wires and Herbert screws. It went on to heal well and at 6 months follow-up, there was no infection or avascular necrosis and wrist function was good