الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
PLDs-PLFDs comprise a spectrum of traumatic soft-tissue and bony insults typically occurred through direct high energy mechanisms or indirect falling on out stretched hyperextended hand. Unfortunately, up to 25% of these injuries are missed initially. The most common PLFDs is the transscaphoid dorsal perilunate fracture dislocation. Which compromise 61% of PLFDs. Perilunate fracture dislocations and lunate dislocations are examples of the carpal instability complex.Perilunate fracture dislocation and lunate dislocation are the end result of a 4-stage progression described by Mayfield et al. with injury transmission progression through the carpus in a radial to ulnar direction.
Accurate early diagnosis is essential; delayed treatment worsens outcomes. The diagnosis is typically made on wrist radiographs, with loss of carpal height and disruption of carpal arcs identified on the AP radiograph and loss of the co-linearity of the radius, lunate, and capitate found on the lateral radiograph. Accurate open reduction is necessary with repair of the interosseous and extrinsic capsular ligaments. Combined dorsal and volar approach produced better results when treating perilunate fracture dislocation.After surgery, immobilization typically is prolonged owing to the extended time necessary to ensure ligamentous healing. After appropriate management, a functional wrist with diminished motion and strength can be expected.Complications of the perilunate dislocation include post-traumatic arthritis, chronic pain, and median nerve dysfunction.