Perilunate Dislocation

Perilunate dislocations are complex and relatively rare injuries, representing approximately 7% of all carpal injuries. These dislocations often result from high-energy trauma, such as motor vehicle accidents or falls from a height, and are frequently accompanied by other significant injuries. Prompt and accurate diagnosis is essential to prevent chronic carpal instability and traumatic arthritis, which may result from delayed or inadequate treatment. 

The stability of the wrist is largely dependent on the intricate network of ligaments and bones within the carpal structure. Perilunate dislocations typically progress through a series of instability stages, as described by the Mayfield classification. 

Drawing on Chi Mei Medical Center's 10-year experience with 30 cases of perilunate dislocations, this presentation will explore the mechanisms of injury, diagnostic challenges, and treatment strategies, with an emphasis on surgical approaches such as open reduction and internal fixation (ORIF). Our findings underscore the critical importance of early surgical intervention to achieve optimal outcomes. Additionally, these cases have further deepened our understanding and refined our approach to managing perilunate dislocations.