Volar Dislocation of the Triquetrum - Case Report and Review of Literature

Abstract

In contrast to triquetral fractures, dislocations of the triquetrum are very uncommon because of the very strong ligamentous support. They occasionally occur in association with complex wrist injuries, isolated dislocations however are extremely rare. We report a case of a male athlete who sustained an isolated volar dislocation of the triquetrum. The injury was treated by open reduction, fixation with Kirschner-wires and direct repair of torn ligaments. Kirschner-wires were removed after 6 weeks and physiotherapy was started. At 3 years follow-up he reported to be free of pain and showed only slightly restricted grip strength and range of motion when compared to his uninjured hand. A review of the literature indicates that final outcomes are usually satisfactory if prompt diagnosis and treatment occurs. However persistent pain and impaired hand function may result because of delayed diagnosis or insufficient repair of associated ligament injuries.

Keywords

Triquetrum - Dislocation - Ligament injury - Wrist injury - Carpal bones

• References

• 1 Kellam HI, McGoey PF. Review of fractures and dislocations of the carpus. Can Med Assoc J 1945; 53 (4) 332-335
• 2 Berger RA. The anatomy of the ligaments of the wrist and distal radioulnar joints. Clin Orthop Relat Res 2001; 383: 32-40
• 3 Soucacos PN, Hartofilakidis-Garofalidis GC. Dislocation of the triangular bone. Report of a case. J Bone Joint Surg Am 1981; 63 (6) 1012-1014
• 4 Frykman E. Dislocation of the triquetrum: case report. Scand J Plast Reconstr Surg 1980; 14 (2) 205-207
• 5 Muller K, Kreitner KF, Wenda K. Isolated dislocation of the os triquetrum-a rare wrist injury. Aktuelle Radiol 1995; 5 (5) 328-330
• 6 Motta A. Rare isolated volar dislocation of the pyramidal bone of the carpus. Policlinico Prat 1953; 60 (33) 1149-1150
• 7 Moritomo H, Goto A, Sato Y et al The triquetrum-hamate joint: an anatomic and in vivo three-dimensional kinematic study. J Hand Surg Am 2003; 28 (5) 797-805
• 8 Ikpeme JO, Hankey S. Dorsal dislocation of the triquetrum: a rare complication of perilunate dislocation. Injury 1995; 26 (7) 497-499
• 9 Lundkvist L, Larsen CF, Juul SM. Dislocation of the lunate, triquetral, and hamate bones. Case report. Scand J Plast Reconstr Surg Hand Surg 1991; 25 (1) 83-85
• 10 Fowler JL. Dislocation of the triquetrum and lunate: brief report. J Bone Joint Surg Br 1988; 70 (4) 665
• 11 Bieber EJ, Weiland AJ. Traumatic dorsal dislocation of the triquetrum: a case report. J Hand Surg Am 1984; 9 (6) 840-842
• 12 Sachar K. Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg Am 2008; 33 (9) 1669-1679
• 13 Weiss LE, Taras JS, Sweet S et al Lunotriquetral injuries in the athlete. Hand Clin 2000; 16 (3) 433-438
• 14 Toms AP, Chojnowski A, Cahir JG. Midcarpal instability: a radiological perspective. Skeletal Radiol 2011; 40 (5) 533-541
• 15 Nishikawa S, Toh S, Miura H et al The carpal detachment injury of the triangular fibrocartilage complex. J Hand Surg Br 2002; 27 (1) 86-89
• 16 Goldberg B, Heller AP. Dorsal dislocation of the triquetrum with rotary subluxation of the scaphoid. J Hand Surg Am 1987; 12 (1) 119-122
• 17 Inoue G. Dorsal dislocation of the triquetrum: a case report. Ann Chir Main Memb Super 1992; 11 (3) 233-236