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Journal of Hand Surgery (British and European Volume)
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*Dislocations
*Hand Injuries and Disorders
*Wrist Injuries and Disorders
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Articles

Traumatic Dislocations of the Distal Carpal Row

C. H. PAI
D. C. WEI

From the Department of Orthopaedic Surgery, Fangliao General Hospital, Pingtung, Taiwan, Republic of China

Correspondence: Chung-Ho Pai, MD, 436-3, Kuang-Fu Road, Pingtung 90037, Taiwan.

13 patients who sustained high-energy crush or blast injury of the carpal bones were reviewed after a mean follow-up period of 30 months. These complex injuries resulted in unusual disruptions of the distal carpal row and adjacent metacarpals. Frequent involvement of the carpometacarpal (CM) joints and violation of the proximal carpal row were also demonstrated. Nine were open injuries, with the majority accompanied by significant soft tissue damage. Treatment included either closed reduction or open reduction and Kirschner wire fixation, and soft tissue procedures as indicated. In this series, the majority of the open injuries gave unfavourable functional results despite adequate carpal, alignment. Several cases had disastrous outcomes related to associated vascular injuries. Closed injuries, on the contrary, followed a relatively benign course. Nevertheless, decreased grip strength persisted in both groups for a long time. Patients with such a complex carpal injury should expect a less favourable prognosis due to the severe nature of the trauma.

Journal of Hand Surgery (British and European Volume), Vol. 19, No. 5, 576-583 (1994)
DOI: 10.1016/0266-7681(94)90119-8
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