A neglected lunate dislocation in the elderly: A case report with insights from contemporary literature

Lunate dislocation (LD) is an uncommon injury in the geriatric population, often occurring in young adults, and is associated with high-energy trauma. It is frequently missed in the acute stage, especially in the emergency department, and up to 25 % remain undiagnosed six weeks later. Chronic LD, particularly neglected/chronic LD (Mayfield Stage 4), is rare and is associated with poor prognosis and long-term complications.

This case report describes a 78-year-old patient with longstanding lunate dislocation resulting from an unknown trauma that was missed by several healthcare providers. A proximal row carpectomy was performed and the patient reported good results.

While there is a consensus on the need to treat acute or chronic lunate dislocation, the optimal treatment protocols remain unclear.

The rarity of this fracture contributes to missed diagnoses; therefore, this report aims to raise awareness and highlight the limited treatment options available for patients in this demographic. A high index of suspicion coupled with appropriate clinical and radiological assessment can identify LD and prevent complications that negatively impact a patient's quality of life.