Total Scapholunate Extrusion Into the Forearm in a Transscaphoid, Transcapitate Perilunate Fracture Dislocation: A Case Report.

CASE: A 50-year-old woman involved in a motorcycle accident sustained a transscaphoid transcapitate perilunate fracture dislocation with complete extrusion of the proximal scaphoid pole and lunate as a unit into the forearm. The patient underwent urgent open reduction and internal fixation (ORIF) with screw fixation of the capitate and Kirschner wire fixation of the scaphoid, midcarpal joint, and lunotriquetral intervals. At 1-year postoperatively, radiographs confirm healing of capitate and scaphoid fractures, with no signs of avascular necrosis of the lunate.

CONCLUSION: Despite a complex fracture-dislocation pattern, treatment with ORIF can successfully lead to scaphoid and capitate union and lunate revascularization.