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

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.