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Age: 24

Sex: Male

Indication: Wrist injury

Save ("V")

Case #15


Findings

  • Acute scaphoid waist fracture with rotation of the proximal fracture fragment
  • Volar subluxation of the lunate with approximately 45 degrees volar tilt
  • Dislocation of the capitolunate joint with dorsal subluxation of the distal carpal row relative to the radius
  • Acute nondisplaced ulnar styloid fracture


Diagnosis

  • Midcarpal dislocation

Sample Report

Acute transscaphoid midcarpal dislocation with the following components:

Acute scaphoid waist fracture with rotation of the proximal fracture fragment.

Volar subluxation of the lunate with approximately 45 degrees volar tilt.

Dislocation of the capitolunate joint with dorsal subluxation of the distal carpal row relative to the radius.

Acute nondisplaced ulnar styloid fracture.


Discussion

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Images

Greater (red line) and lesser (green line) carpal arcs. This is a normal wrist radiograph from a different patient. Midcarpal dislocation: volar subluxation and tilt of the lunate (articular surface outlined in red) and dorsal subluxation of the capitate (articular surface outlined in yellow). Blue line: normal axis of alignment. Midcarpal dislocation with offset of the capitate (yellow line) and lunate (red line) articular surfaces. Scaphoid fracture fragments (red arrows) give the appearance of 4 bones on the proximal carpal row. Greater arc carpal dislocations in order of severity from left to right. Far left: normal. Left center: perilunate dislocation. Right center: midcarpal dislocation. Far right: lunate dislocation.



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