Fixation (closed) of a trans-scaphoid perilunate fracture

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