Transradial, Transscaphoid, Transcapitate, Perilunate Dislocation; A Case Report and Approach to the Patient

Carpal injuries are uncommon and are mainly seen in the younger age group. The incidence is unclear as many of the cases go undiagnosed. A 22-year-old male patient coming to the hospital after road traffic accident with head, face and left wrist injury. After immediate primary management the patient was taken up for a definitive procedure 4 days after the injury. Scaphoid fracture was fixed with the help of Herbert’s screw via the dorsal approach. The base of the first metacarpal was fixed with the help of JESS fixator and the distal end radius was fixed with the help of K-wires. The scapholunate and lunato triquetral ligaments were repaired. The whole construct was stabilized with the help of an external fixator. Postoperative period was uneventful. The external fixator was removed after 4 weeks and patient had a good functional outcome with the patient related wrist evaluation score coming out to be 11 at the end of the third month. This uncommon case of Transradial, Trans scaphoid, transcapitate, and perilunate dislocation was managed successfully with no postoperative complications and a good functional outcome.