Lunate and perilunate dislocations in professional football players. A five-year retrospective analysis

The purpose of this retrospective study was to review the treatment and prognosis of lunate and perilunate carpal dislocations in professional football players in the National Football League over a 5-year period. There were 7 lunate and 3 perilunate dislocations in 10 players. The mechanism of injury was hyperextension in 9 of 10 players. Five players were subsequently treated by closed reduction and percutaneous pinning; the others were treated by open reduction and K-wire fixation. No player was treated by cast immobilization alone. Intraoperative techniques, postoperative immobilization and protection, return to play, final follow-up physical examination, radiographic evaluation, and complications were reviewed. Results of this study clearly demonstrate that lunate and perilunate carpal dislocations do not mean the end of a career in professional football, although a minimum of 4 weeks of playing time is lost. Treatments varied with respect to open or closed reductions, placement of pins, casts, and time of immobilization. None of the variations was clearly superior or detrimental, although four of the five players who returned to play in the same season were treated by closed reduction with percutaneous pinning.