Dorsal trans-scaphoid perilunate dislocation in a 9-year-old child.

The authors reported on the surgical management of a trans-scaphoid retrolunate dislocation of the carpus associated with a stable styloid fracture of the radius and a displaced fracture of the triquetrum in a nine-year-old child. An open reduction of the dislocation and fixation using a screw inserted disto-proximally in the scaphoid were quickly carried out using a palmar approach. X-ray showed a good union nine months later. At 29 months the motion of the wrist was normal and pain-free, the strength was graded at 80 % in comparison to the contralateral side and the X-ray examination showed no carpal instability nor growth trouble. The authors discuss the mechanism of production and the therapeutic strategy.