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Reminder of important clinical lesson
Transscaphoid perilunate dislocation – a tale of two carpals?
  1. Gordon W Cowell,
  2. Chye Yew Ng,
  3. Christopher H Tiemessen,
  4. John E Phillips
  1. Department of Orthopaedic Surgery, Borders General Hospital, Melrose, UK
  1. Correspondence to Dr Gordon W Cowell, gordoncowell{at}


The authors describe two cases of perilunate dislocation with transscaphoid fractures both presenting following hyperextension injuries within 4 days of each other at a district general hospital. After initial management in accident and emergency, both patients underwent open reduction and internal fixation under general anaesthetic, with plaster cast immobilisation and careful clinical follow-up. Given the relative rarity of this injury, the significance of the radiological findings, the degree of associated bony and ligamentous damage and the need for prompt intervention may be overlooked. Thus, a summary of presentation and management of the condition is given to aid junior emergency staff in diagnosis and initial management.

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  • Competing interests None.

  • Patient consent Not obtained.