Perilunate Fracture Dislocations eMedicine Orthopedics

Description: Perilunate dislocations and perilunate fracture dislocations are the most devastating closed injuries of the wrist.1, 2, 3 They are often missed on initial evaluation, leading to devastating complications. These injuries occur as the final stage of a spectrum of injuries progressing around the wrist in a radial-to-ulnar direction. In the setting of a high-energy wrist injury, radiographs must be carefully scrutinized for the presence of the perilunate dislocation or one of its variants. Prompt open reduction with ligamentous repair or reconstruction is necessary to achieve favorable results. Posttraumatic arthrosis may result following these injuries irrespective of treatment, requiring a late salvage operation.
Synonyms and related keywords: perilunate dislocations, de Quervain fracture, de Quervain's fracture, retro-lunate dislocation, retrolunate dislocation, carpal instability complex, wrist injury, wrist pain, carpal instability dissociative, CID, dorsal intercalated segment instability, DISI, volar intercalated segment instability, VISI, carpal instability nondissociative, CIND
Author: Peter M Murray, MD, 2008