Perilunate Dislocation – Case Report and Review of Literature

Subramanian, Karthik; Arora, Bakul; Bhatnagar, Abhinav; Jan, Dr. Imran

doi:10.7860/jcdr/2017/29750.10509

Cited by 9 publications

(10 citation statements)

References 8 publications

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“…The next part of this sequence, the trans-triquetral component, occurs through an avulsion of the long radiocapitate ligament or the palmar ulnotriquetral ligament. There have been reports of perilunate fractures associated with two components of this pattern, but very few have reported the combination of the carpal fractures and the styloid fracture, we observed in our patient [ 2 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 53%

“…Perilunate dislocations are rare, constituting <10% of all wrist injuries, and are associated with poor functional outcomes [ 1 , 2 , 3 ]. These dislocations occur through high-energy injuries through which an axial load is transmitted through the volar aspect of the wrist causing forced extension and ulnar deviation.…”

Section: Discussionmentioning

confidence: 99%

“…Perilunate dislocations are rare high-energy injuries, constituting <10% of all wrist injuries [ 1 ]. The diagnosis is often missed on clinical and radiographic evaluation, up to 25% of cases [ 2 ]. Early recognition and diagnosis of these injuries is prudent to restore patient function and prevent morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Case Study: Trans-styloid, Trans-scaphoid, Trans-triquetral, and Perilunate Dislocation

Frane¹,

Regala²,

Klein³

et al. 2021

JOCR

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Introduction: Perilunate dislocations are rare high-energy injuries, and the diagnosis is not infrequently missed at initial presentation. The combination of fractures resulting in a trans-styloid, trans-scaphoid, and trans-triquetral perilunate fracture dislocation is extremely rare. Early recognition and diagnosis of these injuries is prudent to restore patient function and prevent morbidity. This injury pattern may progress through several distinct phases often involving the greater or lesser arc. The injury begins with traumatic disruption of the scapholunate joint, followed by an ordered progression of injury to the capitolunate, lunotriquetral, and radiolunate joints. When the radiolunate joint is disrupted, the lunate often dislocates volar transposing into the carpal tunnel, associated with median nerve compression. These injuries have the potential to cause lifelong disability of the wrist. Early treatment may prevent or lessen the chance of median neuropathy, post-traumatic wrist arthrosis, chronic instability, and fracture nonunion. Non-operative treatment is not indicated and is associated with poor functional outcomes and recurrent dislocation. Open reduction and internal fixation (ORIF) with ligamentous repair after emergent closed reduction and splinting is indicated for acute injuries (<8 weeks after injury). Case Report: We report a case of a 48-year-old right hand dominant male with a trans-styloid, trans-scaphoid, trans-triquetral, and perilunate dislocation after mechanical fall from height. He was evaluated in the ER and provisionally treated with closed reduction and splinting. ORIF of scaphoid, radial styloid, and triquetrum was performed, with ligamentous repair of the scapholunate joint and carpal tunnel decompression. Conclusion: The combination of fractures/injuries in this case has been very rarely been published in case reports to date. It is necessary to recognize these wrist injuries. Great detail should be given to physical and radiog

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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Case Study: Trans-styloid, Trans-scaphoid, Trans-triquetral, and Perilunate Dislocation

Frane¹,

Regala²,

Klein³

et al. 2021

JOCR

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“…2 It was not until 1980 that Mayfield et al proposed that the injury occurred as a result of hyperextension with ulnar deviation and intercarpal supination and described the four stages of injury. 3 – 6 Weber and Chao attributed the associated scaphoid fracture seen in some cases to the extension of the wrist. 7 , 8 In cases where the scaphoid is fractured, the proximal pole of the scaphoid generally stays connected to the lunate by its ligamentous attachments.…”

Section: Discussionmentioning

confidence: 99%

Perilunate instability: A rare variant

Partap

Persad

2021

SAGE Open Medical Case Reports

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Perilunate dislocations and perilunate fracture dislocations are rare injuries that occur as a result of high energy trauma. We describe a case of a volar fracture dislocation of the proximal pole of the scaphoid with an associated scapholunate and lunotriquetral ligament disruption as well as a lunate fossa fracture of the distal radius. These injuries are serious injuries that require a high degree of clinical acumen and radiographic scrutiny to allow for prompt treatment in order to avoid the sequelae of long-term complications that can arise. This case serves as a reminder of the complexity of these injuries and their associated mechanics.

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“…It is also important to assess neurovascular status on exam since a median nerve injury can occur. 48,49 With regards to imaging, the lateral view will be most indicative of whether a perilunate dislocation is present because it will show dorsal dislocation of the capitate, with the lunate in alignment with the distal radius. The AP view can reveal overlap of the distal and proximal carpal rows, as well as any associated fractures that may be present.…”

Section: Instructor Materialsmentioning

confidence: 99%

Fracture Detectives: A Fracture Review Match Game

Sudario¹,

Hana²

2020

JETEM

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Audience:The target audience for this small group session is emergency medicine residents, primarily for use in didactic conference. This session can also be utilized with medical students or faculty looking to review various orthopedic injuries. 37 SMALLgroupsResearch Methods: Educational content and satisfaction were obtained from learners through in-person interviews at the end of the session. Learners were asked questions regarding relevance, satisfaction with structure of the session, and overall value of the session related to their clinical practice.Results: Overall, residents had high levels of satisfaction after the session, many commenting on how gamification made the session more interactive and interesting. Learners did give feedback regarding needing more time to complete the flipped classroom component of the session, and overall felt like their parts of the presentation were rushed.Discussion: Gamification and flipped classroom learning strategies were effective in teaching the identification and management of common orthopedic injuries. Gamification increased engagement. Flipping the classroom allowed learners to obtain deeper knowledge in one specific diagnosis while learning collectively from the knowledge of an entire cohort.Topics: Extremity bony trauma, dislocations/subluxations, tendon injuries, ligamentous injuries.

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Perilunate Dislocation – Case Report and Review of Literature

Cited by 9 publications

References 8 publications

Case Study: Trans-styloid, Trans-scaphoid, Trans-triquetral, and Perilunate Dislocation

Case Study: Trans-styloid, Trans-scaphoid, Trans-triquetral, and Perilunate Dislocation

Perilunate instability: A rare variant

Fracture Detectives: A Fracture Review Match Game

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