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A Modified Anatomic Front and Back (ANAFAB) Approach Combined Lunate Excision in a Case of Chronic Neglected Lunate

Wei-Lin Chang^1,2, Jung-Pan Wang^1,2

¹Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.

Journal of Wrist Surgery

|January 23, 2026

Abstract

Background:

The treatment of neglected chronic lunate dislocations is controversial while open reduction of lunate was often not available in the situation. Lunate excision, partial wrist fusion, or proximal row carpectomy (PRC) were recommended in several studies, but long-term complications of capsular contracture, carpal collapse, and posttraumatic arthritis were still noted.

Case Report:

We described a 25-year-old male suffering from motor vehicle accident 3 years ago with neglected chronic lunate dislocation. The modified technique of anatomic front and back (ANAFAB) combined with lunate excision was applied in the young and active male. After surgery, 8 weeks of immobilization was adequate and no additional Kirshner wires were needed.

Discussion:

The modified ANAFAB technique revealed the ability of sustaining significant load on the carpus and radius without pain, and the technique not only maintained the carpal stability and good recovery of range of motion but also preserved the options of partial wrist fusion or PRC in the future.

Keywords:

ANAFAB technique carpal dislocation chronic lunate dislocation lunate excision proximal row carpectomy

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