Lunate dislocations: anatomy, diagnosis and management

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Radiology

Background:

• Lunate and perilunate dislocations are rare but severe wrist injuries.
• High-energy trauma is the typical cause, necessitating advanced trauma life support.
• Associated injuries include neurovascular compromise and open wounds.

Purpose of the Study:

• To review the anatomy, diagnosis, and management of acute lunate and perilunate dislocations.
• To emphasize the importance of timely intervention for optimal outcomes.
• To discuss potential long-term sequelae.

Main Methods:

• Review of anatomical structures and injury mechanisms.
• Discussion of diagnostic imaging, including the Mayfield classification.
• Outline of initial management (closed reduction) and definitive surgical treatment (open reduction and ligamentous stabilization).

Main Results:

• Closed reduction in the emergency department can relieve neurovascular pressure.
• Surgical repair aims to restore carpal alignment and ligament stability.
• Most patients return to work within 6 months post-surgery.

Conclusions:

• While functional outcomes are generally adequate, long-term issues like midcarpal arthrosis, chronic pain, and reduced grip strength are common.
• Early diagnosis and appropriate management are key to minimizing complications.
• This review provides a comprehensive overview for clinicians managing these complex wrist injuries.