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Established non-union of an operatively managed trans-scaphoid perilunate fracture dislocation progressing to spontaneous union

Divecha, Hiren M and Clarke, Jon V and Barnes, Steven J (2011) Established non-union of an operatively managed trans-scaphoid perilunate fracture dislocation progressing to spontaneous union. Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology, 12 (3). pp. 159-162.

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Abstract

Perilunate dislocations and fracture dislocations represent uncommon and unusual injuries that are often missed at initial presentation and diagnosed late in up to 25% of cases. Prompt open reduction, carpal stabilisation and ligamentous repair is required to reduce the risk of complications. We report a case of an established scaphoid non-union in an operatively managed perilunate fracture dislocation that spontaneously united almost 2 years after the initial injury, just before a planned revision scaphoid fixation with bone grafting. This case highlights the importance of initial clinical assessment together with appropriate radiographs and follow-up of these injuries post-operatively, especially when complications such as non-union arise.