Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Wrist Case 6 ED Management

Perilunate Dislocation


ED Management

Carpal dislocation injuries require orthopedic consultation in the emergency department for reduction and stabilization. Progessive instability may occur without proper reduction and nerve injury may be present requiring emergent intervention. The consultant will likely use arthroscopically guided reduction with pinning or do open reduction with ligamentous repair. Some sources say that reduction may be attempted by the emergency physician only after contact has been made with the hand surgeon and urgent follow up evaluation has been confirmed.

L= Lunate; C=Capitate