Rotatory subluxation of the scaphoid

Rotatory subluxation of the scaphoid is an uncommon abnormality which is not widely understood. It can be difficult to diagnose and, if incorrectly managed, can lead to a severe and disabling radio-carpal arthritis. While complicating many forms of wrist trauma, its place in the lunate-perilunate dislocation spectrum being especially important, the abnormality may occur in the absence of trauma, such as with rheumatoid arthritis; its association with Kienböck's disease is documented in this paper. The mechanisms underlying the subluxation are discussed and the importance of early diagnosis is stressed. Eight cases of rotatory subluxation of the scaphoid are reported to illustrate the presentations, symptomatology and complexities of diagnosis.