Perilunate dislocation

Case contributed by Dr Sakher Alkhaderi

Presentation

Pain and swelling following a fall on a dorsiflexed wrist

Patient Data

Age: 35 years
Gender: Male
X-ray

The radiograph demonstrates trans-scaphoid fracture and carpus dislocation relative to the lunate .  

CT

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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Case information

rID: 41561
Case created: 8th Dec 2015
Last edited: 29th Jan 2017
Inclusion in quiz mode: Included

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