The progressive perilunar instability model described by Mayfield is still used to predict the pattern of injury. Diagnosis of injury and clinical and radiographic findings depend on the pattern of injury. Open procedures are preferred for anatomic reduction after initial closed reduction is performed for acute injuries. A dorsal, volar, or combined dorsal/volar approach may be necessary and is often decided by surgeon preference. Loss of motion and diminished grip strength are common consequences despite appropriate treatment. Successful outcomes depend on time to treatment, open or closed nature of injury, extent of chondral damage, residual instability, and fracture union.
Perilunate injuries are rare; unfortunately, the consequences of improper recognition and inappropriate management can be debilitating.
Injuries occur as a result of a high-energy load leading to carpal disruption and progressive ligamentous and bone injury.
Loss of motion, diminished grip strength and post-traumatic arthrosis are common consequences despite appropriate treatment.
Successful outcomes depend on time to treatment, open or closed nature of the injury, extent of chondral damage, residual instability, and fracture union.