ArticleJournal of orthopaedic case reports2026
Concomitant Distal Radius Fracture with Scaphoid Fracture-Dislocation and Carpal Instability: A Case Report.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Concomitant ipsilateral fractures of the distal radius and scaphoid are uncommon and are typically associated with high-energy trauma. The combination of a comminuted intra-articular distal radius fracture with scaphoid fracture-dislocation and carpal instability represents a particularly rare and complex injury pattern. Early recognition of associated carpal injuries is important to restore and maintain anatomical alignment. Case Report: A 32-year-old right-hand-dominant man presented with severe pain, swelling, and deformity of the left wrist following a high-energy motorcycle road traffic accident. Radiographs demonstrated a comminuted intra-articular distal radius fracture associated with a displaced scaphoid fracture-dislocation and disruption of carpal alignment. Neurovascular status was intact. Following initial immobilization and resolution of soft-tissue swelling, definitive surgery was performed on day 3. The distal radius was reduced and stabilized through a modified Henry approach using volar locking plate fixation supplemented by dorsal plating. The scaphoid fracture was reduced and stabilized with a Herbert screw, while the associated carpal instability was addressed with Kirschner-wire fixation. Wrist range-of-motion exercises were initiated at 4 weeks, and the carpal Kirschner wires were removed at 6 weeks. At 8 months, radiographs demonstrated complete union of the distal radius and scaphoid with maintained carpal alignment. The patient achieved 40° of wrist flexion and 60° of extension, with a pain score of 3/10 and no limitation in activities of daily living. Conclusion: This case highlights the importance of carefully evaluating carpal alignment in high-energy distal radius fractures to identify associated scaphoid and intercarpal injuries. Comprehensive operative stabilization of the distal radius, scaphoid, and unstable carpal relationships can restore anatomical alignment and provide a stable construct for rehabilitation.
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