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Updated: May 6, 2026

Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Stage 4 Reverse Perilunate Injury: A Proposed Addition to an Existing Classification and Case Report
Caitlin M Ward1, Xavier C Simcock1, Mark S Cohen1
1Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
Abstract:
This report describes a 53-year-old man who sustained a reverse perilunate injury (REPLI) including disruption of all ligaments that have been previously described in addition to the short radiolunate ligament resulting in a dorsal lunate dislocation. This was treated with open reduction and internal pin fixation through a dorsal approach. At final follow-up of four years, the patient had radiographic evidence of ulnocarpal translation. Despite this, he was doing well clinically. We propose that the disruption of the short radiolunate ligament, leading to a dorsal lunate dislocation, should be included in the existing REPLI staging system as a Stage 4 injury.
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