Perilunate Dislocation Anterior-posterior (AP) view (Figure 1) demonstrates the distal and proximal carpal rows overlapping, as well as a complete radial styloid fracture. Lateral view (Figures 2 and 3) demonstrates dorsal dislocation of the capitate, whereas the lunate remains articulated with the radius. More often seen in young men in their teens to twenties, rather than children or the elde...

THE PATIENT A 37-year-old man injured his right wrist in a motor vehicle collision. In the emergency department he had severe wrist pain and median nerve paresthesia. Wrist radiographs identified a dorsal perilunate dislocation (PLD) with the carpus dislocated dorsally and the lunate tilted volar but still located in the lunate fossa. Post-reduction computed tomography scan confirmed no fractures.

Perilunate dislocations are a devastating injury to the carpus that carry a guarded long-term prognosis. Mayfield type 4 perilunate dislocations are rare, high-energy injuries that carry a risk for avascular necrosis (AVN) of the lunate. When AVN ensues and the carpus collapses, primary treatment with a proximal row carpectomy or arthrodesis has been advocated. This case reports a successful cl...

Most carpal dislocations occur in the lunate bone or around it (perilunate). An isolated dislocation of the carpal scaphoid is a rare injury. We report a case of a palmar scaphoid dislocation combined with a dorsal perilunate dislocation, which was treated with open reduction, fixed with two Kirschner wires and ligament repair, with a good result.

Carpal instability is a rare injury of the wrist, but it can cause adverse disability and morbidity of the patient. Lunate dislocation is the fourth and last stage of perilunate dislocation. Bilateral perilunate dislocation is an even more uncommon injury, and only several cases have been reported in literature. We are presenting a case of bilateral perilunate dislocation of wrists in 27-year-o...

A 32 year old man, right-handed soldier, was admitted to Emergency Department two hours after undergoing right wrist injury following a 2 meter fall onto the hand, in hyperextension. Clinical examination revealed a deformity of the wrist with an obvious open lunate enucleation (A). The neurovascular status was intact. Standard radiograph of the wrist demonstrated a completely enucleated lunate,...

Kienbock’s disease (lunatomalacia), first described by Robert Kienbock as ligamentous trauma to the lunate resulting in the interruption of internal arterial supply to the bone [1], is defined as a specific form of avascular osteonecrosis affecting the lunate. Kienbock’s disease is characterized by sclerosis, cystic changes, fragmentation, and articular surface collapse as present on plain radi...

We report the case of a 21-year-old man who injured his right hand in a fall from his motorbike, causing a trans-scaphoid perilunate fracture-dislocation associated with vertical fracture of the pyramid (A and B). On day 2, patient underwent a bloody reduction (C) of disorganized carpal bones with osteosynthesis of scaphoid and pyramid (D). Peri-lunate fracture-dislocation is a rare injury cons...

Figure 1. Radiograph demonstration of a perilunate dislocation: The lunate maintains its normal articulation with the radius, whereas the capitated articular surface is dislocated from the lunate dorsally. Figure 2. Diagrammatic representation of the 3 carpal arcs of Gilula's lines. The first arc is a smooth curve outlining the proximal convexities of the scaphoid, lunate, and triquetrum. The s...

A palmar dislocation of scaphoid and lunate is uncommon. We have found only 19 reported cases in the literature. We reported a simultaneous, divergent dislocation. The closed reduction followed by percutaneous pinning has given a good result without avascular necrosis of any carpal bone.