Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Perilunate dislocation
1.
2. 67 yo F presents after T 98.4 P 87 BP 156/88 O2
losing control of her walker 97%
and falling forward onto Gen: age approp female in
her outstretched, extended obv pain but NAD
right hand. Pt complains of MSK: profound swelling of
10/10 pain in the wrist and
inability to move her wrist. right wrist, no
Denies any other injuries laceration, 2+ distal pulses.
TTP over right wrist and
prox right metacarpals.
Neuro- limited
flexion/extension of right
wrist, otherwise 5/5
strength, nl sensation
5. Pain Management
Reduction of carpal dislocation with longitudinal
traction and dorsal pressure
Ortho consultation needed as often associated carpal
fx present and significant ligamentous injury requiring
open repair
6. Often missed due to inadequate radiographs
Important to get good lateral view to see dislocation
High frequency of associated carpal fractures, usually
scaphoid or radial styloid
Must be cautious of median nerve palsy; can have an
acute carpal tunnel syndrome
Immediate ortho consultation preferred
7.
8. http://www.wheelessonline.com/ortho/perilunate_dislocat
ion
http://radiopaedia.org/articles/perilunate-dislocation
http://www.eorif.com/WristHand/perilunatedislocation.ht
ml
http://www.ispub.com/journal/the_internet_journal_of_or
thopedic_surgery/volume_8_number_1_8/article/concomi
tant_elbow_and_perilunate_dislocation_floating_forearm.
html
http://www.feinberg.northwestern.edu/emergencymed/res
idency/ortho-
teaching/wrist/case67/case67background.html