Wrist and Carpal Dislocations

Dislocations and fracture-dislocations of the wrist are severe injuries resulting from high-energy trauma. Patients may present with a wide range of lesions from isolated ligament injuries to different patterns of fracture-dislocations. The most frequent traumatic carpal dislocations are perilunate fracture-dislocations. Diagnosis is based on clinical examination; however, due to the wide range of injuries that may be present, complimentary imaging is mandatory. The diagnosis should be able to be made with clinical examination and plain x-rays. Systematic evaluation of radiographs is very useful to avoid an incorrect diagnosis. Regarding the treatment, closed reduction must be made as soon as possible in all cases unless surgical treatment is planned immediately, to avoid further damage to the median nerve and cartilage. This chapter is focused on perilunate and radiocarpal dislocations and fracture-dislocations.