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[Palmar lunate dislocation].

J Isenberg¹, A Prokop, F Schellhammer

¹Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie der Universität zu Köln.

Der Unfallchirurg

|December 18, 2002

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Palmar lunate dislocation, a rare carpal injury, often requires open reduction via a palmar approach. Surgical repair and immobilization yield satisfactory functional results despite potential complications.

Area of Science:

Orthopedic Surgery
Trauma Care

Background:

Palmar lunate dislocation is an uncommon end-stage injury of perilunate dislocations.
This study analyzes cases of palmar lunate dislocation resulting from acute hyperextension injuries.

Observation:

Four male patients with palmar lunate dislocation were identified among 19,534 hospitalized trauma patients.
Injuries were caused by falls from height or motorcycle accidents.
Complete palmar lunate dislocations were analyzed in two cases following severe trauma.

Findings:

Urgent open reduction via a palmar approach, ligamentous repair with sutures or anchors, and Kirschner wire stabilization were performed.
Computed tomography assessed reduction and identified associated defects like distal radioulnar joint subluxation.

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Despite a soft tissue infection in one case, subsequent dorsal repair led to satisfactory functional results and carpal stabilization.

Implications:

Open reduction with a palmar approach is indicated for irreducible or unstable dislocations.
Additional dorsal ligamentous repair and wrist immobilization are crucial for stabilizing the carpus.
While ligamentous insufficiency, osteoarthrosis, and avascular necrosis can occur, functional outcomes are generally satisfactory.