Wrist arthrography in acute carpal injuries.

A prospective study of 10 patients with acute complex carpal dislocations was undertaken. Preoperative wrist arthrograms were done in these patients. We then observed the ligamentous tear through both volar and dorsal approaches at the time of open reduction. Perilunate dislocation was always an integral part of the pathology in all patients, except in one patient with radiocarpal dislocation. Communication between the radiocarpal and midcarpal joint was found in all patients, except in one patient with radiocarpal fracture-dislocation. Volar extrusion of the contrast material occurred in all patients except one. Dorsal extrusion occurred only in three patients. The arthrography findings correlated well with the pathology at surgery, as far as indicating the level of the ligamentous disruption. Volar tears were much more common than dorsal tears.