The unreduced carpal dislocation: a concept of treatment.

The treatment of unreduced carpal dislocations and fracture dislocations is controversial. To obtain reduction, an extensive surgical soft-tissue dissection is usually required. The accompanying damage to vessels, ligaments and articular cartilage increases the risk of symptomatic arthritis of the wrist. To avoid this complication as much as possible, a closed technique of treatment has been developed. The method consists of radiocarpal distraction with an external fixator followed by percutaneous reduction and immobilization with the same external fixator. In five out of six patients with an unreduced carpal dislocation this method appeared successful.