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J Wrist Surg 2019; 08(06): 508-512
DOI: 10.1055/s-0039-1677743
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reduction and Association of the Lunotriquetral Ligament for Reverse Perilunate Dislocation

Hui-Kuang Huang
1   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
2   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
3   Department of Orthopaedics, Chiayi Christian Hospital, Chiayi, Taiwan
4   Department of Food nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan
,
Tung-Yeh Tsai
5   Division of Orthopaedics, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
,
Jung-Pan Wang
1   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
2   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
› Author Affiliations
Further Information

Publication History

29 October 2018

26 December 2018

Publication Date:
27 February 2019 (online)

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Abstract

Background Reverse perilunate injuries are rare. Contrary to perilunate injuries, the violent force would start from the lunotriquetral ligament, go reversely toward the radial side, and cause the reverse or ulnar-sided perilunate dislocation.

Case Description We describe a 31-year-old man with a reverse perilunate dislocation, who presented to our institution 3 weeks after a motorcycle accident. The patient was successfully treated with the reduction and association of the lunate and triquetrum (RALT) procedure by using closed maneuver and percutaneous headless compression screw fixation. The patient can obtain a good radiographic result and satisfactory function at the 30-month follow-up.

Literature Review Many case series were reported concerning the perilunate injuries. However, few cases of reverse perilunate dislocation have been reported in the literature. No cases of reverse perilunate dislocation treated 3 weeks after the injury with the RALT procedure have been reported.

Clinical Relevance In this case, we found that the dislocation could still be reduced with the closed maneuver. With the RALT procedure, the carpal alignment can be maintained and the stability can be regained. Also, the functional outcomes are good.

Keywords

carpal dislocation - lunotriquetral ligament - RALT - perilunate - reverse

Note

The work was performed in Taipei Veterans General Hospital, Taipei, Taiwan.