How do you fix a Perilunate dislocation?
The treatment choices for perilunate and lunate dislocations are closed reduction and casting, open reduction-internal fixation-ligament repair, trapeziolunate external fixation, limited wrist arthrodesis and proximal row carpectomy.
How is a lunate fracture treated?
The treatment of an acute, nondisplaced lunate fracture includes immobilization via a cast or an orthosis for 4 to 6 weeks. Lunate fractures that are displaced greater than 1 mm require fragment stabilization with open reduction and internal fixation (ORIF).
How do you treat a Scapholunate ligament tear?
Treatment for a Scapholunate ligament tear This may involve a wrist brace or a cast for 2-6 weeks, minimizing activity that causes pain such a tight gripping or pushing, and anti-inflammatory medications such as ibuprofen.
What is a Perilunate injury?
When dislocation occurs in the wrist, it is typically perilunate, meaning that the bones surrounding the lunate lose their continuity with the lunate through disruption of the ligaments. Usually this involves the capitate dislocating dorsally.
What is Perilunate dislocation?
A perilunate dislocation is disruption of the normal relationship between the lunate and capitate. A lunate dislocation is separation of the lunate from both the capitate and the radius. Perilunate and lunate dislocations result when great force is applied to a hyperextended wrist.
Where is the Perilunate?
Perilunate injuries of the wrist describes the radius-to-ulnar disruption injuries through the scaphoid and capitate bones and ligaments at some distance from the lunate (see the images below).
How is a lunate fracture diagnosed?
We present a case of lunate fracture diagnosed which was diagnosed with cross sectional imaging. Lunate fractures are rare, and most cases in the literature were reported almost exclusively before the era of computed tomography (CT) and magnetic resonance imaging (MRI).
How does a lunate fracture happen?
Lunate fractures occur when the wrist is hyperextended in a fall or from hitting the heel of the hand on a hard surface. The lunate is also prone to dislocation when the scaphoid is fractured. A triquetrum fracture commonly occurs during participation in contact sports.
What is a positive Watson test?
A truly positive test requires both pain on the back of the wrist (not just where you are pressing on the scaphoid tuberosity), and comparison with the opposite wrist is essential.”
What is the difference between lunate and Perilunate dislocation?
What nerve can be affected or injured during a Perilunate dislocation?
Damage to the median nerve is the most commonly associated injury in lunate and perilunate dislocations of the wrist. In certain situations, volar skin lacerations can represent an open dislocation or fracture-dislocation. Symptoms from associated injuries of such fractures of the distal radius and ulna may dominate.
Where is the Perilunate dislocation?
Perilunate dislocations are often associated with fractures of the scaphoid and radial styloid and less commonly with the capitate, triquetrum, and ulna styloid. Wrist radiographs with evidence of these fractures should be scrutinised carefully.
How long does it take for a perilunate dislocation to heal?
Immediate management of a perilunate dislocation entails closed reduction under regional block or general anaesthesia. If closed reduction is successful, a hand surgeon can perform definitive surgery in the next one to two days.
Where is the capitate located in a perilunate dislocation?
Perilunate dislocations usually result from high energy hyperextension injuries to the wrist. In perilunate dislocations, the capitate and other carpal bones are displaced dorsal to the lunate, which remains located in the lunate fossa of the distal radius (fig 1⇓).
When to discuss the bone healing process with your patient?
Why discuss the Bone Healing Process •You can tell your patients that •Most Fractures heal in about 8 weeks •3 months before they feel normal •Up to a year for swelling to resolve •Surgery best done as close to 2 weeks as possible. ACUTE FRACTURE MANAGEMENT • Initial Assessment – •DON’T HAVE TUNNEL VISION, LOOK AT THE WHOLE PATIENT!