Treatment of trans-scaphoid perilunate dislocations by internal fixation with the Herbert screw.

Thirteen patients with 14 dorsal trans-scaphoid perilunate dislocations were treated by open reduction and internal fixation of the scaphoid using a Herbert screw. The follow-up evaluations took place after a mean of 18 months. These perilunate dislocations were only trans-scaphoid in ten wrists, trans-radial styloid and trans-scaphoid in three and trans-scaphoid and trans-capitate in one. Based on Cooney's clinical scoring system, the scores of our series were two excellent, six good, five fair and one poor. This suggests that the Herbert screw can offer satisfactory results in the management of trans-scaphoid perilunate dislocations, despite its technical difficulties.