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"Fracture or no Fracture ? "



Case of the Week 255

What's the most likely diagnosis?

  • 26 year-old with pain in wrist following fall

  1. Fracture of hook of the hamate
  2. Perilunate dislocation
  3. Colles' fracture
  4. Boxer's fracture
  5. Lunate dislocation



5. Lunate dislocation



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Lunate Dislocation

General Considerations

  • Mechanism of injury is usually fall onto an outstretched hand with wrist in ulnar deviation and dorsiflexion
  • Wrist dislocations are uncommon but lunate is the most common bone in the wrist to dislocate
  • Most severe of carpal instabilities
  • Involves all the intercarpal joints and disruption of most of  the major carpal ligaments
  • Capitate and all other carpal bones will lie posterior to lunate on lateral radiograph

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