RESEARCH ARTICLE


Isolated Dorsal Dislocation of the Lunate



NA Siddiqui*, 1, SP Sarkar2
1 Upper Limb Unit, Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland 4102, Australia
2 Department of Trauma and Orthopaedics, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, Essex SS0 0RY, UK


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Creative Commons License
© Siddiqui and Sarkar; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Upper Limb Unit, Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland 4102, Australia; Tel: +61 7 3176 6106; Fax: +61 7 3176 5156; E-mail: nashat75@gmail.com


Abstract

Lunate dislocations are well described in the volar direction as part of the perilunate dislocation, sometimes together with fractures of the other carpal bones or distal radius, as described by the anatomical studies of Mayfield [1]. It is a result of disruption of the complex inter-carpal and radiocarpal ligaments that hold the well conforming carpus in their normal position. Given the strength of these structures a significant trauma is required to cause them to fail.

However, we present a case of a patient who not only presented with relatively trivial trauma that resulted in a lunate dislocation, but it was also in the dorsal direction and not associated with any fracture or neurological compromise. In addition, she presented several days after her injury.

We treated her with closed manipulation and percutaneous K-wire fixation followed by a short period of immobilisation in a Plaster-of-Paris cast, with rapid return to full duties at work.

As many volar lunate dislocations may be missed at presentation, we suggest that in patients with relatively trivial trauma there should also be a suspicion of the lunate dislocating dorsally, which may be treated successfully without the aggressive open surgery usually required in volar perilunate dislocations.

Keywords: : Carpus, dislocation, dorsal, ligament rupture, lunate, perilunate.