DISPLACEMENT OF THE SEMILUNAR CARPAL BONE

An Analysis of Twelve Cases

(1) This injury occurs far more often than is recognized.

(2) Stereoscopic pictures should be taken of all wrist injuries.

(3) A true dislocation of the semilunar carpal bone occurs only when it becomes extra articular, namely, when its relationship with both the os magnum and radius has been completely disturbed.

(4) The term "displacement" may be applied to any degree of change from its normal position.

(5) The persistent dorsal displacement of the mid carpal row produces a permanent disability in the wrist. In the early instances it may be restored to normal position, but if allowed to remain is extremely difficult, if not impossible, to cure.

(6) Closed reduction should be attempted only within forty-eight hours of the injury, and then with extreme caution as to traumatizing the flexor tendons and the articular surface of the carpal bone.

(7) Open reduction is attended with a great deal of danger of traumatizing the articular surface of the flexor tendons. The convalescence is long and the end results unsatisfactory.

(8) Removal of the bone should be done in all cases where dorsi and palmar flexion are limited to the extent of interfering with the patient's work. Early motion following operation should be emphasized.

(9) In Class A cases, where the interim between injury and operation does not permit of the closed reduction method and where the rotation on the radial articulation is not sufficient to cause displacement of the articulation with the os magnum, thus leaving a sufficient function in flexion and extension, the operator should carefully consider non-treatment.

(10) All end results should be based upon the ability of the individual to do his original work.

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