Open reduction and internal fixation of chronic perilunate dislocation

We present a case of two-month inveterate perilunar luxation treated by open reduction and internal fixation. A dual dorsal and palmar approach was used. The palmar access allowed opening of the carpal tunnel and reinsertion of the volar ligaments. The dorsal approach in turn allowed the use of a radial-base capsular flap to reduce the inveterate luxation and reinsert the scapholunar interbone ligament. The reduction was stabilized with three temporary Kirschner pins and immobilization for 6 weeks. Open reduction and internal fixation two months after inveterate perilunar luxation is the method of choice, in place of proximal carpectomy or partial arthrodesis.