Perilunate Injury Combined with Lunate Fracture

ABSTRACT

We present an atypical case of combined comminuted lunate fracture and the scaphoid waist fracture, chip fracture of triquetrum and pisiform. Comminuted scaphoid waist fracture was caused by forced hyperextension of the wrist, similar mechanism to stage I of progressive perilunate instability (PLI), and lunate fracture might be caused by axial compression force, does not appear on the original theory of PLI. We performed closed reduction and screw fixation for the scaphoid fracture and immobilized and mildly distracted the wrist joint with the use of a bridging external fixator to prevent further collapse of comminuted lunate by neutralizing the compression force imposed by the capitate on the lunate. We achieved excellent radiological and clinical outcomes at 29-months of follow-up. We aimed to introduce this rare injury and clinically important points in its treatment with the review of the literature.