Lunate fracture

Background

• Isolated lunate injuries are rare
• Occurs via FOOSH mechanism
• Blood supply enters distal end
• Fracture puts proximal portion at risk for avascular necrosis (Kienbock’s disease)

Clinical Features

• Axial compression applied along 3rd metacarpal elicits tenderness

Differential Diagnosis

Carpal fractures

AP view

• Scaphoid fracture
• Lunate fracture
• Triquetrum fracture
• Pisiform fracture
• Trapezium fracture
• Trapezoid fracture
• Capitate fracture
• Hamate fracture

Diagnosis

• PA and lateral views
• MRI/CT may be required to identify occult fractures

Management

• Short arm thumb spica splint
• Ortho referral

Disposition

• Outpatient

See Also

Wrist Fracture

References

• Tintinalli