Perilunate dislocation is often associated with fracture of the scaphoid. Lunate and perilunate dislocations are reduced with open repair and stabilization, especially of the fractured scaphoid. The MCP joints of the other digits may also dislocate, with the metacarpal head becoming buttonholed between the flexor tendon and the lumbrical. MCP dislocations are characterized by pain, limited movement, and digit deformity. Open reduction and surgical repair are frequently required.
Dorsal dislocations are more common than volar.
A true lateral x-ray should be obtained to rule out a fracture. Splinting for 4 wk is usually adequate. The hook of hamate may be fractured while striking the ground with a stick or making a divot playing golf. Clinically, this fracture is suspected by tenderness over the hook of hamate in the palm. It is also indicated by pain on resisted flexion of the little finger, which localizes to the region of the hamate.