Lunate fracture

Lunate fracture
A lunate fracture as seen on CT scan of the wrist
SpecialtyHand surgery
SymptomsWrist pain and swelling[1][2]
ComplicationsAvascular osteonecrosis, wrist instability, arthritis[3][1]
TypesPalmar pole, distal pole, transverse, osteochondral, transarticular body[1]
CausesFall onto the hand[2]
Diagnostic methodPlain X-rays, CT scan, bone scan, MRI[1]
Differential diagnosisKienböck disease, congenitally bipartite lunate[1]
TreatmentNot displaced: Casting[1]
Displaced: Surgery[1]
Frequency0.5% to 4% wrist breaks[1][3]

Lunate fracture is a break of the lunate bone of the wrist.[3] Symptoms may include pain to the back and front of the wrist and wrist swelling.[1][2] Moving the wrist worsens symptoms.[2] Complications may include avascular osteonecrosis, wrist instability, and arthritis.[3][1]

The cause is often a fall onto the hand.[2] Types include palmar pole, distal pole, transverse, osteochondral, and transarticular body.[1] Diagnosis is typically confirmed by plain X-rays, CT scan, bone scan, or MRI.[1] Other conditions that may appear similar include Kienböck disease and congenitally bipartite lunate.[1]

Treatment of cases in which the bones remain well aligned is by orthopedic casting for 4 to 6 weeks.[1] If the peices of bone are not well aligned or the dorsal aspect is broken, surgery is generally required.[1]

Lunate fractures represent about 0.5% to 4% of breaks of bones within the wrist.[1][3] It is less commonly than scaphoid, triquetrum, and trapezium breaks.[2] The lunate was named by Lyser in 1653 and breakdown of the lunate was found at anatomic dissection before 1900.[4][5]

Diagnosis

Teisen classification is a system of categorizing lunate fractures.[6]

Type Description
I Volar pole fracture
II Chip fracture not affecting the blood supply
III Fracture of dorsal pole
IV Sagittal fracture through the body
V Transverse fracture through the body

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Suh, N; Ek, ET; Wolfe, SW (April 2014). "Carpal fractures". The Journal of hand surgery. 39 (4): 785–91, quiz 791. doi:10.1016/j.jhsa.2013.10.030. PMID 24679911.
  2. 1 2 3 4 5 6 "Lunate fractures - OrthopaedicsOne Articles - OrthopaedicsOne". www.orthopaedicsone.com. Archived from the original on 25 September 2021. Retrieved 13 September 2022.
  3. 1 2 3 4 5 Murphy, Andrew. "Lunate fracture | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Archived from the original on 6 August 2021. Retrieved 13 September 2022.
  4. ↑ Cooney, William P. (21 December 2011). The Wrist: Diagnosis and Operative Treatment. Lippincott Williams & Wilkins. p. 468. ISBN 978-1-4511-4826-8. Archived from the original on 27 September 2022. Retrieved 24 September 2022.
  5. ↑ Cooney, William P. (21 December 2011). The Wrist: Diagnosis and Operative Treatment. Lippincott Williams & Wilkins. p. 26. ISBN 978-1-4511-4826-8. Archived from the original on 27 September 2022. Retrieved 24 September 2022.
  6. ↑ Zhang, Yingze; Xing, Xin (2018). "4. Classification of hand and wrist fractures". In Zhang, Yingze (ed.). Clinical Classification in Orthopaedics Trauma. Springer: Springer. p. 229. ISBN 978-981-10-6044-1. Archived from the original on 2022-09-27. Retrieved 2022-09-24.
This article is issued from Offline. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.