Perilunate Dislocation about Two Cases of an Often Missed Injury

Abstract

Perilunate dislocations are rare and constitute 5% to 10% of all wrist injuries. They are related to ligament injuries. The lunate bone has a precarious vascularization, and any neglect of this pathology could damage the bone and compromise the functional prognosis of the wrist. The patient interview will allow to determine the exact mechanism of the injury as well as the dominant limb. Clinical examination may lead to the identification of probable lesions. Conventional radiography is systematic. It allows to establish the diagnosis, look for associated lesions, and to grade the lesion according to Mayfield’s classification. The aim of the treatment is to obtain a better functional result. The choice of approach is guided by the associated lesions, in particular a scaphoid fracture or median nerve compression. Reduction must be done as soon as possible with stabilization using pins. Rehabilitation after a wrist dislocation should be systematic. We report two cases of perilunate dislocation that were diagnosed on the day of the trauma using imagery. Open reduction and fixation of the dislocation with Kirschner wires was performed in both patients. After 9 months in the first case and 12 months in the second one, results were satisfying with resumption of normal activity in both cases.