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Orthopaedics · Dislocations: greater arc carpal injury
Sample itemA motorcyclist has a perilunate dislocation with a fracture through the scaphoid waist. What is the term for this injury and how is it classified?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Trans-scaphoid perilunate fracture-dislocation, a greater arc injury
Greater arc injuries pass through the bones around the lunate, such as the scaphoid, capitate and triquetrum, and the trans-scaphoid perilunate fracture-dislocation is the commonest. Lesser arc injuries pass through the ligaments around the lunate. Treatment is urgent reduction and fixation, often with open repair.
Option by option
A. Trans-scaphoid perilunate fracture-dislocation, a greater arc injury (correct)
Correct. A fracture through the scaphoid with perilunate dislocation is a greater arc injury.
B. Scapholunate dissociation alone
Scapholunate dissociation is a ligament injury without perilunate dislocation.
C. Lesser arc injury with pure ligament disruption
Lesser arc injuries involve ligaments only and no fracture.
D. Barton fracture-dislocation
Barton fracture involves the distal radius articular margin.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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