Argos, a 49-year-old patient who came to Dr. Piñal’s surgery after suffering a crushed left wrist two days ago. There was a fracture of the head of the big one, with a torn hooked hook and multiple osteoligamentous lesions. “They told me that they couldn’t guarantee the movement of my wrist…”.

On 4 December 2021, Argos went for a consultation and on the same day underwent surgery at the Hospital Vithas Madrid La Milagrosa under locoregional anaesthesia. Once under anaesthesia, the deaxation of the ulnar digits, which were rotated towards the ulna due to the injury mechanism, was confirmed. First of all, the hooked hook that was free in the carpal canal was removed. The wound is closed in one plane. During traction for arthroscopy, fluoroscopy checks that the large head and the first row are congruent while there is complete separation between the second and first carpal rows. The large one is reduced through a limited dorsal approach, and after arthroscopic verification of good joint congruence, it is synthesised with two 2.0 mm, 22 mm long Autofix screws. It is filled with cancellous bone from the hooked hook. Finally, the first row is reduced to the second row and fixed with two 1.22 mm needle screws. The wounds are dressed in planes and the patient is immobilised with a volar splint.

After the operation the patient is discharged with antibiotic and analgesic treatment.