26-year-old male professional sportsman (football player) with no other personal history of interest for the case in question. He suffered a fall from his own height while playing sport, resting his left wrist and hyperextending it. As a result of the trauma, he presented pain, deformity and functional impotence, with a normal distal neurovascular examination.
Anteroposterior and lateral radiographs of the wrist showed a fracture of the radial styloid process, a fracture of the lunate bone and a dislocation through the fracture line of the lunate. The dorsal fragment of the lunate is attached to the carpal bones and displaced dorsally, while the volar fragment is in its anatomical position. In view of this image, we diagnose a transstiloid radial-transmillunar fracture-dislocation.

We proceeded urgently to a closed reduction of the dislocation by means of traction and immobilisation, verifying the instability of the injury. We also performed a post-reduction CT scan, observing that the fracture of the lunate bone was coronal-oblique and comminuted.

72 hours after the trauma, and after performing a supraclavicular block, the patient underwent surgery using a dorsal approach with opening of the dorsal retinaculum at the level of the third slide and capsulotomy according to Berger's technique (8). We then proceeded to reduce the fracture of the lunate by stabilising it with a 2 mm diameter mini-screw, and to repair the scapholunate ligament with a harpoon in the lunate. Total limb ischaemia time was 74 minutes.

After 6 weeks of cast immobilisation, the patient was referred to rehabilitation until stabilisation of the condition with functional limitation: 35o flexion, 25o extension, full pronation-supination, and no radiocarpal or midcarpal instability, which allowed him to return to his previous sporting activity 5 months after the trauma. At the one-year check-up, the process is stabilised, with no worsening.

