RESUMEN
Peri lunate and lunate dislocations are rare injuries associated with high energy impacts on a hyperextended and outstretched wrist. One-fourth (of peri lunate dislocations are missed at the initial presentation. We report a case of volar lunate dislocation along with proximal pole scaphoid and trapezium fracture in a patient who presented with high energy trauma. After the initial reduction of the dislocated lunate, he underwent open reduction internal fixation and soft tissue repair using through volar and dorsal approach. This was followed by K-wire removal and aggressive physiotherapy activities. At the end of three months he regained full movements with no recurrence of dislocation. Overall Peri lunate/lunate dislocation are one of the most important differential diagnosis in high energy injuries which requires immediate attention to prevent the potential risk of avascular necrosis of lunate, scaphoid leading to secondary osteoarthritis. As the injury transitions occurs from a dorsal peri lunate to a palmer lunate pattern, the most likely mechanism involved is a sheer fracture of the proximal pole of the scaphoid by the dorsal lip of the distal radius.
RESUMEN
Primary septic arthritis of the Acromioclavicular joint is an unusual disorder and is seldom seen even in an immunocompromised person. We report a case of primary septic arthritis of the acromioclavicular (A-C) joint caused by Staphylococcus aureus. The patient was admitted with pain in the left shoulder, restricted movements and fever. Laboratory parameters showed elevated C-reactive protein, raised erythrocyte sedimentation rate and leukocytosis. Ultrasound revealed a 32 mm collection at the acromioclavicular joint. Patient underwent incision and drainage of abscess. Culture and sensitivity revealed moderate growth of Staphylococcus-aureus. Patient was started on appropriate intravenous antibiotics. Magnetic resonance imaging (MRI) done after 2 weeks revealed marked erosion in the lateral end of clavicle with soft tissue collection along the posteromedial aspect A-C joint. The patient had to undergo repeat drainage of the abscess along with the decompression of lateral end of clavicle. The patient was successfully treated with 8 weeks of appropriate antibiotics with complete resolution of infection.