Dorsal Lunate Dislocation Classification and Proposal for Treatment

Yael Cohen Noam Shohat Gabriel Agar Erez Avisar
Orthopedics, Assaf HaRofeh Medical Center, Zerifin, Israel

Purpose: Dorsal lunate dislocations are uncommon injuries of the wrist joint with minimal data on their acute management. The purpose of this study was to review current data and offer a management strategy for these injuries.

Methods: We systematically searched online databases to identify case reports or case series of dorsal lunate dislocations. Two reviewers independently extracted data and evaluated the eligibility of each study. Patient demographics, mechanism of injury, predisposing factors, treatment strategy and functional outcome were documented. We add a description of an exceptional type of carpal instability which combines a fracture of the radial styloid with an open dorsal dislocation of the lunate.

Results: We were able to locate three case reports describing an isolated dorsal lunate dislocations and four reports describing a dorsal lunate dislocation accompanied with either a fracture or tendon injuries. A thorough review of the literature on the subject has led the authors to introduce a treatment oriented classification system for dorsal lunate dislocation.

Conclusions: Treatment of dorsal lunate dislocation should be based mainly on the underling mechanism and energy of the injury. We offer a comprehensive classification for these injuries.