Challenges in Postoperative Compliance and Follow-Up Among Trauma Patients: A Case Report of a Trans-scaphoid Perilunate Dislocation

The wrist joint is a complex articulation that involves the distal radius, ulna, eight carpal bones (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate), and the bases of the metacarpals. Trans-scaphoid perilunate fracture-dislocations are complex wrist injuries, most commonly resulting from high-energy mechanisms involving hyperextension and ulnar deviation. Prompt diagnosis and surgical management are essential in restoring wrist function and stability. This report focuses on the case of a 28-year-old male who sustained a trans-scaphoid perilunate dislocation with multiple associated fractures after an all-terrain vehicle (ATV) rollover accident. Surgical intervention included median nerve decompression, open reduction and internal fixation (ORIF) of the scaphoid, and stabilization of the lunate and associated carpal bones. After receiving initial postoperative care, this patient demonstrated noncompliance with follow-up and rehabilitation, highlighting the challenges that social determinants of health can pose in trauma patient management. This report emphasizes the role of surgical management and postoperative compliance in optimizing patient outcomes.