Wrist Dislocations eMedicine Emergency

Description: Carpal dislocations represent a continuum of wrist injury that can lead to lunate or perilunate dislocation. The lunate cup commonly is directed in a volar direction in dislocation because of the mechanism of the injury. Perilunate dislocations result from dislocation of the distal carpal row. The capitate normally rests within the lunate cup, as seen on a lateral view. With perilunate dislocations, the capitate is seen most commonly as dorsal, but it also may be volar to the lunate on lateral x-ray evaluation. As a result of the stresses involved, scaphoid fractures often accompany perilunate dislocation. Carpal instability may take many forms and represents a spectrum of injury including scapholunate dissociation, lunate and perilunate dislocations, scaphoid fracture, and other intercarpal instabilities.
Author: Michael S Beeson, MD 2004