RESEARCH ARTICLE


Volar Perilunate Dislocation: A Case Report and Review of the Literature



B Youssef*, S.C Deshmukh*
The Hand Service, The Royal Orthopaedic Hospital, Northfield, Birmingham, UK


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Creative Commons License
2008 Bentham Science Publishers Ltd.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to these authors at the Department of Hand Surgery, The Royal Orthopaedic Hospital, Bristol Road South Northfield, Birmingham, B31 2AP, UK; Tel: +44121 685 4000, Ext. 55399; Fax: +44121 685 4213;E-mail: bishoy_youssef@hotmail.com or subodh.deshmukh@roh.nhs.uk


Abstract

Perilunate dislocations, lunate dislocations and perilunate fracture dislocations are rare injuries comprising of less than 10% of all wrist injuries. Volar peri-lunate dislocations (VPLDs) account for less than 3% of perilunate dislocations. These severe carpal injuries occur after high-energy trauma to the wrist and falls on the outstretched hand. We present a case of a missed VPLD who developed parasthesia in the distribution of the median nerve 18 months after the initial injury. A plain film radiograph revealed a stage II VPLD. Nerve conduction studies confirmed compression of the median nerve at the carpal tunnel. VPLDs are extremely rare injuries. A quarter of perilunate dislocations are missed on initial presentation. The outcome is poor for missed injuries and this patient is aware that a wrist fusion may be required in the future for to treat symptoms.