- Dislocation of the lunate relative to the radius and distal row of metacarpals, most are volar but can be dorsal
- Usually from high-energy hyperextension with ulnar deviation of the wrist
- Implies disruption of all 4 perilunate ligaments and radiocarpal ligament (Mayfield classification, stage IV)
- In volar dislocations, median nerve injury occurs in the carpal tunnel
- Associated fractures of the radial styloid, scaphoid, capitate, and triquetrum are common and, if present, should raise suspicion of an occult perilunate ligamentous injury
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