ORTHOPEDICSTREATMENT
Reduction by orthopedist
COMPLICATIONS
Median nerve injuries, acute carpal tunnel syndrome, early arthritis, avascular
necrosis
PERILUNATECARPALDISLOCATION
Most common carpal dislocation
MECHANISM
FOOSH (again, significant forces involved) with wrist hyperextension and
disruption of carpal ligaments.
DIAGNOSIS
Teacup is upright but the capitate does not sit on top of the lunate (capi-
tate is most frequently found dorsallydisplaced sitting on top of radius; see
Figure 4.6).
TREATMENT
Reduction and orthopedic consultation
FIGURE 4.5. Lunate dislocation. “Piece-of-pie-shaped” lunate on the frontal view is a
clue but the “spilled teacup” (see arrow) on lateral view is diagnostic. Normally the axis of
the lunate should line up with that of the distal radius and the capitate on the lateral view.
FIGURE 4.6. Perilu-
nate dislocation. The
“teacup” (lunate) is up-
right but the capitate is
positioned posterior to
the lunate.