Brachial Plexus Injury and Repair--General Orthopaedics: Fractures

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and Dislocations: Late Treatment of a Dorsal Transscaphoid, Transtriquetral Perilunate *Wrist* Dislocation With Avascular Changes of the Lunate. Gellman-Harris. Schwartz-Steven-D. Botte-Michael-J. Feiwell-Lawrence. Clinical Orthopaedics and Related Research. 1988 Dec. 237. pp 196-203. The outcome of delayed treatment of an unreduced transscaphoid, transtriquetral, perilunate fracture dislocation of the carpus is unpredictable. Long-term follow-up observations in a 22-year-old man treated three months postinjury showed changes in the lunate consistent with avascular necrosis at the time of open reduction and internal fixation. Early resolution of this was evident by nine months, and complete resolution was seen at the follow-up examination (four years and two months). Despite delay in treatment, this patient had full, pain-free *wrist* motion. Consequently, avascular changes of the carpus following *wrist* dislocation do not preclude a good result. Anatomic reduction of the scaphoid, as well as the midcarpal joint, and restoration of the articular surface of the lunate, are most important in determining prognosis.