Lunate fracture
Background
- Isolated lunate injuries are rare
- Occurs via FOOSH mechanism
- Blood supply enters distal end - proximal fracture fragment at risk of avascular necrosis (Kienbock’s disease)
Clinical Features
- Tenderness elicited by axial compression applied along 3rd metacarpal
Differential Diagnosis
Evaluation
- Hand x-ray (PA and lateral views)
- MRI/CT may be required to identify occult fractures
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Immobilization
Disposition
- Discharge with referral to orthopedic surgery
See Also
References
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