Presentation
High speed motor vehicle collision.
Patient Data
Volar lunate dislocation, with no scaphoid fracture seen.
Ulnar negative variance and severe 1st CMC degenerative change noted.
Volar lunate dislocation, without evidence of scaphoid fracture.
This indicates disruption of the scapholunate, lunotriquetral and dorsal radiocarpal ligaments.
The dislocated lunate invaginates the carpal tunnel and displaces the flexor tendons and neurovascular structures volarly.Tiny (2-2.5 mm) bony fragment lies immediately dorsal to the proximal pole of the capitate. Significant soft tissue swelling is noted throughout the carpus.
There is negative ulnar variance. Severe degenerative change noted at the 1st CMC joint.
Case Discussion
Lunate dislocation needs to be differentiated from perilunate dislocations. Both of these injuries are often overlooked and require prompt treatment.
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