Late treatment of unreduced perilunate dislocations

Twenty-eight patients with perilunate dislocations that had been untreated for a minimum of 6 weeks after injury were assessed at a mean of 6.8 years after subsequent treatment. Treatment consisted of open reduction with or without internal fixation of the scaphoid in six patients, proximal row carpectomy in 16, total excision of the lunate in four, and carpal tunnel release and partial excision of the lunate in two. Open reduction yielded satisfactory results in cases of less than 2 months standing. We believe that proximal row carpectomy should be considered in the treatment of chronic perilunate dislocations in patients who are seen later than 2 months after injury, if the cartilage of the proximal pole of the capitate is well preserved. The results of lunate excision were less favourable.