Summary about Disease
Volar lunate dislocation is a wrist injury where the lunate bone, one of the eight carpal bones in the wrist, is displaced forward (volarly) out of its normal articulation with the radius and capitate. This is a serious injury that can compromise wrist function and lead to chronic pain and arthritis if not treated promptly and effectively. The injury is often associated with disruption of various ligaments in the wrist.
Symptoms
Significant wrist pain, often described as deep and aching.
Swelling and bruising around the wrist.
Limited range of motion of the wrist.
Deformity of the wrist (may be subtle).
Numbness or tingling in the fingers (especially the median nerve distribution - thumb, index, middle finger, and radial half of the ring finger) due to compression of the median nerve in the carpal tunnel.
Weakness of grip strength.
Causes
Volar lunate dislocations are typically caused by high-energy trauma to the wrist. Common causes include:
Falls onto an outstretched hand (FOOSH).
Motor vehicle accidents.
Sports injuries.
Medicine Used
Pain relievers: Over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be used for mild pain. Prescription pain medications, such as opioids, may be necessary for more severe pain.
Anti-inflammatory drugs: NSAIDs (Non-steroidal anti-inflammatory drugs) such as ibuprofen or naproxen can help reduce inflammation and pain.
Anesthesia: Local, regional, or general anesthesia may be used during the reduction or surgical procedure.
Is Communicable
Volar lunate dislocation is not communicable. It is a traumatic injury and cannot be spread from person to person.
Precautions
Prevent falls: Take measures to prevent falls, especially in environments with slippery surfaces.
Use protective gear: Wear appropriate protective gear during sports and activities that carry a risk of wrist injury.
Safe driving practices: Practicing safe driving to avoid car accidents can help prevent wrist injuries, among many others.
Early treatment: Seek prompt medical attention after any wrist injury to ensure proper diagnosis and treatment.
How long does an outbreak last?
Since volar lunate dislocation is not communicable or an outbreak related condition, this question does not apply. The "outbreak" duration depends on the injury itself and its recovery time, which can vary from weeks to months, or even longer, depending on the severity of the injury and the treatment received.
How is it diagnosed?
Physical examination: A doctor will examine the wrist for swelling, tenderness, deformity, and range of motion.
X-rays: X-rays are crucial for visualizing the dislocation of the lunate bone and any associated fractures. Different views of the wrist are taken.
CT scan: A CT scan may be ordered to provide more detailed images of the bones and joints in the wrist, especially if there are complex fractures or to better assess the extent of the dislocation.
MRI: An MRI scan can help visualize soft tissue injuries, such as ligament tears, which are commonly associated with lunate dislocations.
Nerve conduction studies: If nerve compression is suspected, nerve conduction studies may be performed to assess the function of the median nerve.
Timeline of Symptoms
Immediate: Severe pain, swelling, and limited wrist motion occur immediately after the injury.
Within hours: Bruising develops, and numbness or tingling may begin.
Days to weeks (untreated): Pain persists, wrist stiffness increases, and grip strength weakens. If left untreated, chronic pain, instability, and arthritis can develop over time.
Important Considerations
Prompt treatment is essential: Delayed treatment can lead to chronic wrist pain, instability, arthritis, and nerve damage.
Associated injuries: Volar lunate dislocations are often associated with other wrist injuries, such as fractures of other carpal bones or ligament tears. These injuries must also be addressed during treatment.
Surgical intervention is often required: While closed reduction (manipulating the bone back into place without surgery) may be attempted, surgical intervention is often necessary to stabilize the wrist and repair damaged ligaments.
Rehabilitation is crucial: Physical therapy is essential after treatment to regain strength, range of motion, and function of the wrist.
Potential complications: Complications of volar lunate dislocation and its treatment can include stiffness, pain, arthritis, nerve damage, and hardware failure (if surgery is performed).