Transient vascular compromise of the lunate after fracture-dislocation or dislocation of the carpus

Abstract

Although classic avascular necrosis of the lunate is rare after fracture-dislocation or dislocation of the carpus, these severe carpal injuries can compromise the vascular supply of the lunate. The lunate thus develops a relative increase in radiodensity. Our finding of an incidence of 12.5%--three of 24 cases--suggests a relatively frequent occurrence. The clinical course was transient with resolution of abnormal radiodensity and subjective findings. Moreover, none of the three cases progressed to classic avascular necrosis of the lunate, Kienböck's disease. The clinician should not confuse this transient vascular compromise of the lunate with Kienböck's disease, but should be aware of the entity and its benign, self-limited course and should treat it expectantly.