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Dislocations of the wrist: carpal instability complex

  • Peter M Murray
    Correspondence
    Address reprint requests to Peter M. Murray, MD, Associate Professor, Division of Hand and Microvascular Surgery, Department of Orthopedic Surgery, The Mayo Graduate School of Medicine, Senior Associate Consultant, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224, USA
    Affiliations
    Division of Hand and Microvascular Surgery, Department of Orthopedic Surgery, The Mayo Graduate School of Medicine, Rochester, MN and the Mayo Clinic, Jacksonville, FL, USA
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      Abstract

      Dislocations involving the carpus are among the most devastating injuries of the wrist. The more commonly encountered perilunate dislocations occur as the final stage of a mechanism progressing in a radial to ulnar direction. These injuries often are missed initially, potentially leading to serious complications. Patients presenting with high energy injuries about the wrist must be scrutinized carefully using standard wrist radiography and occasionally tomography. All dislocations of the carpus require prompt reduction. Better results from perilunate and lunate dislocations can be expected when dorsal and volar surgical approaches are used and the scapholunate interosseous ligament is repaired. Wrist stiffness, posttraumatic arthritis, and median nerve dysfunction may complicate carpal dislocations, even after early surgical attention.
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