Perilunate Injuries: Current Aspects of Management

Dorsal spanning plate fixation in perilunate injuries: a case report

“…There is no consensus on the management of perilunate injuries. Described interventions encompass utilizing closed reduction and percutaneous pinning, ORIF and ligamentous repair, arthroscopy, external fixation, proximal row carpectomy, or wrist arthrodesis depending on the acuity and severity of the injury [ 1 , 2 , 4 , 5 , 7 , 8 , 11 , 14–16 ]. Yet even with these treatments, perilunate injuries lead to long term sequelae such as pain, stiffness or posttraumatic arthritis in up to 80% of patients [ 7 ].…”

“…Mayfield staging was initially presented in 1980 and detailed the predictable pathomechanical process of sequential ligamentous rupture and joint disruption that occurs in perilunate injury progression ( Table 1 ) [ 1 , 3 , 4 , 10 , 11 ]. The most severe stage IV perilunate injuries, or lunate dislocations (LD), commonly occur volarly into the space of Poirier [ 3 , 6 , 8 , 10 ].…”

“…The most accepted initial management principles for perilunate injuries often involve emergent closed reduction, neurovascular monitoring, and definitive surgery within three to five days [ 1 , 3–5 , 11 ]. Surgery includes open reduction and internal fixation (ORIF) of any bony injuries followed by soft tissue ligamentous repairs as necessary [ 1 , 3–5 , 11 ]. Popular methods to achieve a stable fixation involve the use of K-wires, screws, or cerclage wires, followed by cast immobilization [ 4 , 5 ].…”

Simultaneous quadruple dislocations of the hand in a motorcyclist: A case report

“…Finally, regarding perilunate dislocation, the closed reduction should be performed as soon as possible to prevent further damage to the median nerve and cartilage. However, closed reduction in stage IV perilunate dislocations like in our our case is almost impossible making the open approach inevitable [ 24 ]. Both dorsal and volar approaches have been used in the open reduction of perilunate dislocations.…”

Trans-scaphoid Lunate Dislocation Rare Injury: A Case Report

“…Computed tomography (CT) scans are particularly valuable as they offer a more comprehensive view of the injury's extent and assist in treatment planning [ 3 ]. Management of lunate fracture dislocation often requires prompt surgical intervention to restore the normal alignment of the wrist and stabilize the damaged structures [ 6 ]. Understanding the complexity of lunate fracture dislocation is critical for healthcare workers caring for patients with wrist injuries, as it will guide them in making informed decisions about the most effective therapy techniques.…”