Unusual case report of concomitant lunate and scaphoid fractures without associated dislocation in a 16-year-old male

Abstract

Introduction and importance: Lunate fractures without associated dislocations are rare injuries, combination scaphoid-lunate fractures without an associated dislocation are even more rare of which few are reported in the literature.

Case presentation: This case report describes a 16-year-old otherwise healthy male with ipsilateral scaphoid and lunate fractures after punching a goalpost with his left hand, for which he had surgical management. This patient had a successful treatment with two headless compression screws through a single extended carpal tunnel approach. Surgery was performed within two weeks of injury after initially immobilized with a thumb spica splint. The postoperative period was complicated by noncompliance with weight-bearing status and missed three-month followup. However, by six months, subsequent visits demonstrated radiographic and clinical healing as well as full wrist range of motion without any other sequelae.

Clinical discussion: This case offers more evidence regarding this rare injury. Lunate fractures and scaphoid fractures can both be treated with open reduction and internal fixation using headless compression screws, however little evidence exists when it comes to treating them in combination.

Conclusion: The use of headless compression screws through a single extended carpal tunnel approach led to clinical and radiographic healing in a 16 year-old-male with combined scaphoid and lunate fractures at 6 month follow up.

Keywords: Carpal fractures; Case report; Headless compression screw; Lunate fracture; Scaphoid fracture.