TRAUMATIC DISLOCATIONS OF THE DISTAL CARPAL ROW

13 patients who sustained high-energy crush or blast injury of the car pal bones were reviewed after a mean follow-up period of 30 months. Th ese complex injuries resulted in unusual disruptions of the distal car pal row and adjacent metacarpals. Frequent involvement of the carpomet acarpal (CM) joints and violation of the proximal carpal row were also demonstrated. Nine were open injuries, with the majority accompanied by significant soft tissue damage. Treatment included either closed re duction or open reduction and Kirschner wire fixation, and soft tissue procedures as indicated. In this series, the majority of the open inj uries gave unfavourable functional results despite adequate carpal ali gnment. Several cases had disastrous outcomes related to associated va scular injuries. Closed injuries, on the contrary, followed a relative ly benign course. Nevertheless, decreased grip strength persisted in b oth groups For a long time. Patients with such a complex carpal injury should expect a less favourable prognosis due to the severe nature of the trauma.