Lunate dislocations require urgent ED orthopedic consultation for reduction and stabilization. These injuries are very unstable, and may be reduced by the emergency physician only after contact with the orthopedist. Early reduction and stabilization is required to minimize the chances of subsequent Kienbock disease, or avascular necrosis of the lunate.
Due to ligamentous instability, a long arm cast is required after reduction. Urgent follow with the specialist is important. These injuries will often require arthroscopically-guided reduction and pinning or open reduction with ligament repair.