Abstract
Purpose We reviewed a series of equivalents of perilunate dislocations and fracture-dislocations
(PLDs–PLFDs) in which there was no dislocation of the capitate from the lunate on
the initial radiographs. We propose to include these injuries as a variant of perilunate
dislocations that we have termed a perilunate injury, not dislocated (PLIND) lesion
in a modified classification of perilunate injuries.
Methods A review of the records of all acute perilunate injuries and displaced carpal fractures
was done in a single-center university hospital wrist surgery unit over a 5-year period.
All cases presenting at the acute stage with displaced fractures of scaphoid, lunate,
triquetrum, or capitate along with scapholunate and/or lunotriquetral dissociation
but no dislocation of the capitate from the lunate in the sagittal or coronal plane
were reviewed and considered as PLIND lesions.
Results We identified 11 patients with PLIND lesions. Three cases with clinical and radiological
follow-up are presented.
Discussion Equivalents of PLDs–PLFDs presenting without dislocation of the capitate from the
lunate do exist. These injuries may be overlooked despite their severity. They require
both osseous and ligamentous repair. Including them into an existing perilunate injuries
classification highlights their recognition and enables a better understanding and
treatment of both acute and chronic nondislocated perilunate injuries.
Level of Evidence Level IV, retrospective case series.
Keywords
perilunate dislocations - perilunate fracture - dislocations - greater arc - lesser
arc - wrist
