Missed Perilunate Dislocation in a Post-Traumatic Head Injury Patient: A Case Report

Perilunate injuries are rare, complex, and high velocity trauma associated injuries accounting to <10% of wrist joint trauma. Volar peri-lunate dislocations account for <3% of these injuries. Perilunate injuries should, therefore, be focused and ruled out while examining a patient complaining wrist pain after high-energy accidents which are often missed.

We report a case of, missed dislocation in a patient who presented delayed with wrist pain, post 4 months road traffic accident associated with heterotrophic ossified mass in a united scapular fracture. He underwent open reduction through a combined approach and internal fixation with K-wires. Aggressive wrist physiotherapy retrieved near-normal range of motion at the wrist by the end of 5 months as well as neither revealed recurrence of the dislocation nor signs of avascular necrosis.

Successful results in perilunate injuries can be obtained with open reduction, ligament reconstruction with K-wires fixation through a single combined approach in delayed presentation resulting in achieving near normal range of movements.