Perilunate Injuries, Not Dislocated (PLIND)

Abstract

Purpose We reviewed a series of equivalents of perilunate dislocations and fracture-dislocations (PLDs–PLFDs) in which there was no dislocation of the capitate from the lunate on the initial radiographs. We propose to include these injuries as a variant of perilunate dislocations that we have termed a perilunate injury, not dislocated (PLIND) lesion in a modified classification of perilunate injuries.

Methods A review of the records of all acute perilunate injuries and displaced carpal fractures was done in a single-center university hospital wrist surgery unit over a 5-year period. All cases presenting at the acute stage with displaced fractures of scaphoid, lunate, triquetrum, or capitate along with scapholunate and/or lunotriquetral dissociation but no dislocation of the capitate from the lunate in the sagittal or coronal plane were reviewed and considered as PLIND lesions.

Results We identified 11 patients with PLIND lesions. Three cases with clinical and radiological follow-up are presented.

Discussion Equivalents of PLDs–PLFDs presenting without dislocation of the capitate from the lunate do exist. These injuries may be overlooked despite their severity. They require both osseous and ligamentous repair. Including them into an existing perilunate injuries classification highlights their recognition and enables a better understanding and treatment of both acute and chronic nondislocated perilunate injuries.

Level of Evidence Level IV, retrospective case series.

Keywords

perilunate dislocations - perilunate fracture - dislocations - greater arc - lesser arc - wrist

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