Lunate dislocation with avulsed triquetral fracture: A case report

Lunate dislocation is an uncommon traumatic wrist injury that require prompt surgical management. Misdiagnosis or delayed treatment often leads to a poor outcome. Open reduction and surgical repair of disrupted ligaments are done in most cases to prevent long-term joint dysfunction. However, this method has certain limitations that include partial functional improvement, which poses a high risk for degenerative arthritis and wrist instability.

A 37-year-old man presented to the Emergency Department of our hospital following a motorcycle accident. Physical examination revealed swelling and tenderness of the right hand and wrist. The patient was initially misdiagnosed with a wrist contusion by an emergency physician, but was eventually diagnosed with lunate dislocation associated with a triquetral avulsed fracture, indicated for open reduction and ligament repair. We performed closed reduction and two Kirschner wire fixations following Tavernier's method. The injured hand was protected with a standard short-arm orthosis for one month. The patient returned to normal daily work without discomfort at five months postoperatively. Encouragingly, there was no lunate necrosis or arthritis in the latest radiologic examinations.

This case provides evidence that the closed reduction technique for addressing such cases can reduce soft tissue destruction.