Acute perilunate dislocations

In reviewing the literature on acute perilunate dislocations, we found wide disagreement as to the best treatment for these injuries. A fundamental background on the evolution and evaluation of the perilunate dislocation is given, in which the older literature was found to support initial closed treatment. Subsequent follow-up has proved that open treatment may actually give similar, yet more predictable, results. It is concluded that in most patients--and especially in a noncompliant city hospital population--open reduction-internal fixation will achieve the best overall results in the treatment of these injuries.