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.
Highlights
A 53 year-old unemployed right hand dominant gentleman presented with numbness in his left hand
A plain film radiograph revealed a stage II volar perilunate dislocation (VPLD) and radio-scaphoid osteoarthritis (Fig. 1). This is a very rare injury and to our knowledge a presentation of Volar peri-lunate dislocations (VPLDs) this length of time after injury has not been previously reported in the literature
VPLD are extremely rare only accounting for 3% of all perilunate dislocations
Summary
A 53 year-old unemployed right hand dominant gentleman presented with numbness in his left hand. He fell onto his hyperextended wrist 18 months ago. The Disability of Arm Shoulder and Hand (DASH) score was 68 points This outcome measure is a 30-item, self-reported questionnaire designed to measure physical function and symptoms in people with musculoskeletal disorders of the upper limb. A plain film radiograph revealed a stage II volar perilunate dislocation (VPLD) and radio-scaphoid osteoarthritis (Fig. 1) This is a very rare injury and to our knowledge a presentation of VPLD this length of time after injury has not been previously reported in the literature. He currently remains on the waiting list for a carpal tunnel decompression
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
