Acute coronal plane scaphoid fracture and scapholunate dissociation from an axial load: a case report.

Abstract

Coronal fractures of the scaphoid are rare and can be difficult to diagnose. Axial load injuries that result in a complete coronal fracture of the scaphoid associated with an acute scapholunate dissociation are exceedingly rare. In our patient the radiographic finding of wide scapholunate dissociation was obvious; however, the coronal scaphoid fracture was not recognized initially nor suspected. During surgery the coronal scaphoid fracture was identified, reduced anatomically, and fixed with a compression screw. The scapholunate ligament also was repaired. A good result was obtained with return to sports with extension of 60 degrees and flexion of 70 degrees , grip strength equal to that of the uninjured wrist, and no radiographic problems (arthrosis, avascular necrosis, nonunion).