Perilunate dislocation
Presentation
Pain and swelling following a fall on a dorsiflexed wrist
Patient Data
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The radiograph demonstrates trans-scaphoid fracture and carpus dislocation relative to the lunate .
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There is evidence of fracture of the lateral aspect of distal radius and trans-scaphoid fracture with multiple bone fragments seen in the dorsal aspect of the intercarpal joint , the carpus is dislocated dorsally relative to the lunate which remains normal alignment with the radius ( slight widening of the radiolunate joint is noted ) , appearances are consistent with tran-scaphoid perilunate dislocation
Case Discussion
Perilunate dislocation are potentially devastating high energy closed wrist injuries and are often missed on initial imaging , these injuries involve dislocation of the carpus relative to the lunate which remains in normal alignment with the distal radius , around 60% are associated with trans-scaphoid fracture .
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