An unusual fracture dislocation pattern in a patient with an os lunatotriquetrum

Lunatotriquentral fusions are fairly uncommon. An unusual fracture dislocation pattern from a severe wrist injury in the presence of a congenital os lunatotriquetrum is presented. The authors suggest anomolous carpal mechanics secondary to the carpal coalition as the reason for the unusual fracture pattern. Restoration of the pre-injury carpal orientation and internal fixation yielded a satisfactory result.