Fixation (closed) of a trans-scaphoid perilunate fracture
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X-rays showing a trans-scaphoid perilunate dislocation of the wrist. A complex injury with a fracture of the scaphoid and complex ligament i |
Closed in situ fixation of the scaphoid i.e. the wrist was not opened but surgery was performed by tiny incisions 1 mm each side |
The scaphoid has been fixed. Now the triquetrolunate ligament injury is held reduced with a wire |
A second wire is placed across the triquetro-lunate joint. Note how the wire carefully does NOT penetrate the far side of the lunate bone |
Screw carefully placed down the wire crossing the middle of the joint |
The position of the srew is shown. The guide wire remains long. |
The guidewire is cut short and left under the skin for easy removal of the screw at 3 months when the ligament has repaired. |
The x-ray shows the very good positions of the screws. These are difficult to place in such complex bones |
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