Fractures and dislocations involving the navicular-lunate axis

This is a report of experience with 48 carpal disruptions including anterior dislocations of the lunate, transnavicular perilunate and perilunate dislocations and subluxation of the navicular. The correct radiographic diagnosis is absolutely essential for effective treatment. Many of these injuries may be treated by closed reduction, but open reduction of transnavicular perilunate dislocations is the procedure of choice. Avascular necrosis of the lunate may follow open dislocation. Primary subluxation of the navicular may occur without dislocation of the lunate.