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Abstract
Carpal dislocations are wrist injuries and Lunate dislocation is its severe form. Lunate and perilunate dislocations are uncommon. These injuries have significant clinical impact on the patient but are easily missed and lead to potentially devastating effect if mismanaged. This case report outlines the important clinical aspects and management of Lunate dislocation.
Keywords: Lunate, dislocation.
Introduction
Wrist has a complex anatomy with multiple bones and joints that lead to infinite combination of positions and movements. Although wrist fracture/ dislocation is a rare entity among all cases of extremity trauma, but a number of specific injuries should be looked for to rule out their presence. Lunate dislocation is such injury1.
The morbidity of carpal dislocation is frequently associated with missed diagnosis of lunate dislocation in the emergency department due to the complex structure of the wrist. Unfortunately, missed injuries of the wrist are associated with a high incidence of long-term pain and disability .
The true incidence of lunate dislocation is unknown, but the carpal dislocations are estimated to account for 10% of all wrist injuries3.
Lunate dislocation results from hyperextension of the wrist due to high energy trauma to the wrist. This often results from fall on the outstretched hand, motor vehicle and motorcycle crash .
In lunate dislocation, there is disruption between the lunate bone and the lunate fossa of the radius. This requires emergent reduction and stabilization using either closed or open surgery with internal fixation. A lunate dislocation with median nerve symptomatology requires immediate surgical reduction, carpal tunnel release and ligamentous reconstruction5 .
Case Report
A 45 years old male presented to the Accident & Emergency department of Armed Forces Hospital, Southern Region, Khamis Mushayt, Kingdom of Saudi Arabia, with the complaints of left wrist pain. He was involved in sports activities and had a history of fall on an outstretched left hand. He complained of pain, swelling, trouble in moving his left wrist along with numbness of...