UNASSIGNED: Multiple carpal fractures or fracture dislocations can be devastating to the wrist. Despite anatomical reduction and ligament reconstruction, reduced function and arthrosis is often observed. Simple fractures without ligament injuries often fare well if anatomy is restored and the fracture heals.
UNASSIGNED: A 17-year-old autistic man presented with pilon-type bilateral fractures of the carpals after crashing his bicycle in a car with clenched fists around his bicycle handlebars. He had a displaced scaphoid, minimal displaced capitate and an undisplaced hamate fracture on the left side and an undisplaced scaphoid and displaced two-part capitate fracture on the right side. The fractures were reduced and stable fixation with screws performed. He was immobilized for 2 weeks and allowed early active motion. At 8 weeks the fractures had healed, and he obtained good function. At final follow-up after 6 months his nearest of kin reported excellent function, he had returned to his preinjury activity level. Range of motion and grip-strength was excellent and symmetrical. Radiographs and CT scans revealed healed fractures in anatomical position, no sign of ligament injuries, carpal instability or arthrosis.
UNASSIGNED: Multiple carpal fractures are not necessarily prone to reduced wrist function, pain and arthrosis, even in bilateral cases. If the ligaments are intact, stable fixation obtained and early mobilization obtained the fractures reduced and stable fixation obtained excellent hand and wrist function can be obtained.

UNASSIGNED: Scapho-capitate syndrome is a rare variety, usually occur during high-energy trauma leads to fracture of scaphoid and capitate with 180 rotation of proximal fragment of capitate.
UNASSIGNED: We present a unique case of chronic neglected scapho-capitate syndrome, in which the rotated proximal fragment of capitate along with the early degenerative changes in capitate and lunate.
UNASSIGNED: Exploration of the wrist by dorsal approach, fracture fragment was resorbed and non-amenable for fixation. The scaphoid and triquetrum were excised. The cartilage between the lunate and capitate was denuded and arthrodesis was performed by 2.5 mm headless compression screw. The articular branch of the posterior interosseous nerve (PIN) was excised for pain relief.
UNASSIGNED: Accurate diagnosis in acute injury is essential for functional outcome. In chronic cases, magnetic resonance imaging is necessary to know the status of cartilage for planning of surgery. Limited carpal fusion with neurectomy of articular branch of PIN can give adequate pain relief and improvement in wrist function.

A 35-year old healthy male trauma surgery chief resident, suffered a high-speed motor vehicle collision. The patient sustained the following injuries: a Gustilo-Anderson grade 2 open comminuted intra-articular fracture of the left distal femur (AO 33C3.3), a Hawkins 1A neck fracture of the right talus (AO 81.2A), an undisplaced Lisfranc injury of the right foot comprising avulsion fractures at the base of the 1st, 2nd and 5th metatarsal as well as the cuboid bone suggesting ligament injury and 2nd to 5th carpometacarpal dislocations of the right (non-dominant) hand with comminuted fractures of the capitate, hamate, trapezoid and the base of the fifth metacarpal bone. A staged-treatment approach ensued. An external fixator (ex-fix) was placed over the left knee, followed by definitive fixation of the distal femoral fracture using a Qwix screw, Non-Contact Bridging (NCB) plate and Locking Compression Plate (LCP). An ex-fix was placed over the right wrist, followed by open reduction and k-wire fixation. The talar fracture of the right foot was treated with a single lag screw and the Lisfranc injury was treated non-operatively with four weeks of non-weight bearing cast immobilization. An intensive clinical rehabilitation program was started, including early use of Continuous Passive Motion (CPM), daily non-weightbearing swimming pool exercises, hand, physical and recreational therapy. One year after the injury the patient was rehabilitated and resumed his surgical residency. Two years after the injury, limited flexion and pain in the left leg remains, possibly related to partial union of the femoral fracture. Range of motion (ROM) of the right ankle and wrist remains limited, not causing significant functional impairment. Lessons learned from a patient experience combined with detailed descriptions of injuries, rehabilitation and long term outcomes can be used as a reference for treating patients with comparable injuries.

BACKGROUND: Lunate dislocation is a rare and serious injury, frequently due to high-energy trauma such as a fall from height or a motor vehicle accident. Lunate dislocation is usually in the volar direction; however, dorsal dislocation of the lunate is extremely rare.
METHODS: We report a case of 55-year-old male who sustained a high-energy trauma; he was hit by a car while crossing the street. The patient was referred to department of Plastic Surgery for left wrist dorsal dislocation of the lunate and bilateral multiple carpal bone fractures. He was managed by open reduction and internal fixation with scapholunate ligament repair for the left wrist, while the right wrist was treated conservatively.
CONCLUSIONS: Such cases must be treated urgently to avoid complications such as avascular necrosis of the lunate, median nerve injury, complex regional pain syndrome, and chronic carpal instability.
CONCLUSIONS: This case is one of few cases reported in the literature highlighting the rarity of this injury pattern.

Dislocation of all 5 carpometacarpal (CMC) joints of a single hand is a rare injury.
The literature regarding CMC fracture-dislocations was reviewed and a case was presented.
The relevant literature was consolidated to clinically relevant categories including \'Clinical Presentation and Diagnosis,\' \'Management of CMC Fracture Dislocation and Hamate Fractures,\' and \'Outcomes.\'
The mechanism associated with this injury is often high energy that causes multiple simultaneous life- or limb-threatening injuries that could distract the examiner from identifying this injury. The case we present involves an axial dislocation of the carpus that resulted in dorsal dislocations of all CMC joints, dislocation of the hamate-capitate articulation, as well as fractures of the first metacarpal and the hamate.