Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 May:130:111308.
doi: 10.1016/j.ijscr.2025.111308. Epub 2025 Apr 15.

A neglected lunate dislocation in the elderly: A case report with insights from contemporary literature

Nelo J Z C Lima  1 , Onur Başçı  1 , Vasfı Karatosun  1
Affiliations
Case Reports

A neglected lunate dislocation in the elderly: A case report with insights from contemporary literature

Nelo J Z C Lima et al. Int J Surg Case Rep. 2025 May.

Abstract

Introduction: Lunate dislocation (LD) is an uncommon injury in the geriatric population, often occurring in young adults, and is associated with high-energy trauma. It is frequently missed in the acute stage, especially in the emergency department, and up to 25 % remain undiagnosed six weeks later. Chronic LD, particularly neglected/chronic LD (Mayfield Stage 4), is rare and is associated with poor prognosis and long-term complications.

Case presentation: This case report describes a 78-year-old patient with longstanding lunate dislocation resulting from an unknown trauma that was missed by several healthcare providers. A proximal row carpectomy was performed and the patient reported good results.

Discussion: While there is a consensus on the need to treat acute or chronic lunate dislocation, the optimal treatment protocols remain unclear.

Conclusion: The rarity of this fracture contributes to missed diagnoses; therefore, this report aims to raise awareness and highlight the limited treatment options available for patients in this demographic. A high index of suspicion coupled with appropriate clinical and radiological assessment can identify LD and prevent complications that negatively impact a patient's quality of life.

Keywords: Chronic; Dislocation; Geriatric; Lunate bone; Neglected; Proximal row corpectomy.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.

Figures

Fig. 1
Fig. 1
Preoperative radiographs (PA, lateral views) of the right wrist demonstrating volar lunate dislocation. (A) PA view: Disruption of Gilula's arc, and triangular appearance of lunate Lunate or “piece-of-pie-sign” and overlap of lunate with other carpals could be observed. (B) Lateral view: lunate seen displaced and angulated volarly, “spilled teacup” appearance and lunate has lost articulation with capitate or radius.
Fig. 2
Fig. 2
Computer tomography 3D reconstruction of the right wrist demonstrating lunate displaced and angulated volarly, “spilled teacup“appearance and lunate has lost articulation with capitate or radius.
Fig. 3
Fig. 3
Demonstrates anterior-posterior (AP) view of the right wrist after proximal raw carpectomy.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Ramponi D.R., Good A.E. Perilunate and lunate dislocations. Adv. Emerg. Nurs. J. 2023;45:119–122. doi: 10.1097/TME.0000000000000453. - DOI - PubMed
    1. Goodman A.D., Harris A.P., Gil J.A., Park J., Raducha J., Got C.J. Evaluation, management, and outcomes of lunate and perilunate dislocations. Orthopedics. 2019;42:e1–e6. doi: 10.3928/01477447-20181102-05. - DOI - PubMed
    1. Bhatia M., Sharma A., Ravikumar R., Maurya V.K. Lunate dislocation causing median nerve entrapment. Med. J. Armed Forces India. 2017;73:88–90. doi: 10.1016/j.mjafi.2015.12.006. - DOI - PMC - PubMed
    1. Dhillon M.S., Prabhakar S., Bali K., Chouhan D., Kumar V. Functional outcome of neglected perilunate dislocations treated with open reduction and internal fixation. Indian J. Orthop. 2011;45:427–431. doi: 10.4103/0019-5413.83138. - DOI - PMC - PubMed
    1. Linkous M.D., Pierce S.D., Gilula L.A. Scapholunate ligamentous communicating defects in symptomatic and asymptomatic wrists: characteristics. Radiology. 2000;216:846–850. doi: 10.1148/RADIOLOGY.216.3.R00SE15846. - DOI - PubMed

Publication types