The management of dislocations of the carpal lunate

Thirty cases of dislocation of the carpal lunate, without scaphoid fracture, have been reviewed. The angular relationship of the scaphoid and lunate following reduction was measured and also any widening of the scapholunate articulation (scapholunate gap). A close correlation was found between these measurements and the clinical result. If the scapholunate angle falls within a certain range this presages a satisfactory result. If after initial reduction there is radiological evidence of increased scapholunate separation or an unacceptable scapholunate angle, then further reduction must be undertaken to obtain the required bony relationships. If this can be achieved by simple manipulation, the more confident attitude is justified. Although it seems reasonable to suppose that open reduction can improve the position, there is no reported evidence that this is so.