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Perilunate dislocation.

Reisler T, Therattil PJ, Lee ES - Eplasty (2015)

View Article: PubMed Central - PubMed

Affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ.

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Trauma screening shows no other injuries, and wrist radiographs are obtained (Figs 1a and 1b)... In addition, once a perilunate dislocation is reduced, there is usually a radiographic evidence of scapholunate dissociation as a result of ligamentous injury and flexion of the scaphoid... Anteroposterior radiographs will show an increased scapholunate gap known as the “Terry-Thomas sign”; and a scaphoid “Ring sign” as a result of the distal pole of the scaphoid moving relatively closer to the proximal scaphoid cortex and being viewed end-on... Most dorsal perilunate dislocations are the result of an indirect mechanism of injury, usually an extreme extension of the wrist, associated with a variable degree of ulnar deviation and midcarpal supination, often secondary to violent trauma such as sustained from a fall from a height or a motorcycle accident... Perilunate dislocations can be classified as either greater arc or lesser arc injuries depending on the site of trauma and the extent of carpal bone injury... The pattern of injury traverses both the greater and lesser carpal arcs... When the wrist has been distracted for 10 minutes, traction is released, and the method of reduction of dorsal perilunate dislocations described by Tavernier is attempted as follows: with one hand, the patient's wrist is extended (maintaining longitudinal traction), while the thumb of the other hand stabilizes the lunate on the palmar aspect of the wrist... To facilitate this maneuver, the operator's thumb stabilizes the lunate to prevent its being displaced forward by the capitate... When the lunocapitate joint is reduced, and without releasing traction, the wrist is extended gradually while the lunate is pushed dorsally with the thumb, and a full reduction is usually achieved... At this point, traction is released, and the wrist is brought back to neutral... The sooner after the injury this technique is performed, the easier is the reduction... Postreduction radiographs must be taken (Fig 4)... The forearm is maintained elevated until a definitive surgical treatment can be instituted... If the dislocation is reduced, delaying the definitive treatment several hours or even a few days to get the right equipment and trained personnel is not a problem, as long as there is no neurovascular compromise.

No MeSH data available.


Related in: MedlinePlus

Radiograph demonstration of a perilunate dislocation: The lunate maintains its normal articulation with the radius, whereas the capitated articular surface is dislocated from the lunate dorsally.
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Figure 1: Radiograph demonstration of a perilunate dislocation: The lunate maintains its normal articulation with the radius, whereas the capitated articular surface is dislocated from the lunate dorsally.

Mentions: A 30-year-old man is brought to the emergency department after a motor vehicle collision. He complains of right wrist pain. Trauma screening shows no other injuries, and wrist radiographs are obtained (Figs 1a and 1b). The right hand is moderately swollen with diffuse tenderness. The findings of wrist and hand neurovascular examinations are normal. Range of motion is limited by pain.


Perilunate dislocation.

Reisler T, Therattil PJ, Lee ES - Eplasty (2015)

Radiograph demonstration of a perilunate dislocation: The lunate maintains its normal articulation with the radius, whereas the capitated articular surface is dislocated from the lunate dorsally.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321386&req=5

Figure 1: Radiograph demonstration of a perilunate dislocation: The lunate maintains its normal articulation with the radius, whereas the capitated articular surface is dislocated from the lunate dorsally.
Mentions: A 30-year-old man is brought to the emergency department after a motor vehicle collision. He complains of right wrist pain. Trauma screening shows no other injuries, and wrist radiographs are obtained (Figs 1a and 1b). The right hand is moderately swollen with diffuse tenderness. The findings of wrist and hand neurovascular examinations are normal. Range of motion is limited by pain.

View Article: PubMed Central - PubMed

Affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Trauma screening shows no other injuries, and wrist radiographs are obtained (Figs 1a and 1b)... In addition, once a perilunate dislocation is reduced, there is usually a radiographic evidence of scapholunate dissociation as a result of ligamentous injury and flexion of the scaphoid... Anteroposterior radiographs will show an increased scapholunate gap known as the “Terry-Thomas sign”; and a scaphoid “Ring sign” as a result of the distal pole of the scaphoid moving relatively closer to the proximal scaphoid cortex and being viewed end-on... Most dorsal perilunate dislocations are the result of an indirect mechanism of injury, usually an extreme extension of the wrist, associated with a variable degree of ulnar deviation and midcarpal supination, often secondary to violent trauma such as sustained from a fall from a height or a motorcycle accident... Perilunate dislocations can be classified as either greater arc or lesser arc injuries depending on the site of trauma and the extent of carpal bone injury... The pattern of injury traverses both the greater and lesser carpal arcs... When the wrist has been distracted for 10 minutes, traction is released, and the method of reduction of dorsal perilunate dislocations described by Tavernier is attempted as follows: with one hand, the patient's wrist is extended (maintaining longitudinal traction), while the thumb of the other hand stabilizes the lunate on the palmar aspect of the wrist... To facilitate this maneuver, the operator's thumb stabilizes the lunate to prevent its being displaced forward by the capitate... When the lunocapitate joint is reduced, and without releasing traction, the wrist is extended gradually while the lunate is pushed dorsally with the thumb, and a full reduction is usually achieved... At this point, traction is released, and the wrist is brought back to neutral... The sooner after the injury this technique is performed, the easier is the reduction... Postreduction radiographs must be taken (Fig 4)... The forearm is maintained elevated until a definitive surgical treatment can be instituted... If the dislocation is reduced, delaying the definitive treatment several hours or even a few days to get the right equipment and trained personnel is not a problem, as long as there is no neurovascular compromise.

No MeSH data available.


Related in: MedlinePlus