Perilunate Dislocation in a Collegiate Football Player

Authors:
Julian Cazares, Matt Lor, Juana Cervantes, Victor Alvarez

Overview:
In this case review, a 20 year-old African American football cornerback hit his dorsiflexed wrist on the opposing player’s helmet. Different procedures were given in order to help the healing process. X-rays were taken to diagnose the situation.  Anesthesia was injected to reduce the pain, but it was unsuccessful.  Physicians used finger trap splints to create traction for a successful closed reduction, confirmed by a radiographer. The athlete was then splinted and referred to an orthopedic hand and wrist specialist.  According to the MRI scan, the ligament was torn. The ECRB tendon weave procedure with K-wine reinforcement.  They need support and protection so they applied a short-arm cast on him.  Lastly, thermoplastic splints were worn by the athlete to limit motion and he was recommended to continue range of motion exercises.  “Although perilunate dislocation is not a career-ending injury, the method of treatment varies and its long-term prognosis is not highly predictable.”(Waugh, 2009)

Development:
Perilunate dislocation is a low risk injury, but it is extremely uncommon making up only 3% of all carpal injuries and is incredibly rare in athletics. Perilunate dislocation usually occurs when someone falls from extreme heights. In order to avoid a perilunate dislocation to progress into a serious injury, it is essential to seek immediate care. Perilunate dislocation is an uncommon injury so quickly diagnosis if necessary. (Waugh, 2009)

This article helped us find out about perilunate dislocation and its symptoms of this particular injury. As athletic trainers this got us thinking about perilunate dislocation this increased our awareness about this very rare injury. In order to decrease severe injury it is essential to limit  range of motion as much as possible in order to keep it in place and to replenish the injury to avoid any further dislocation. The bright side to this injury is that the athletic can still perform with this injury. Unfortunately, the athlete will need to play with support for example a brace or any other type of protection to keep on performing. (Waugh, 2009)



Conclusion:
In conclusion, perilunate dislocation is pretty difficult to diagnose by just inspecting. Fortunately, it could quite simply be diagnosed by palpating the carpals to check if their is a gap somewhere in the carpals. Gladly, it is it is not a very severe injury and classified as a minor injury if treated in time and correctly. Athletes can still perform and initiate their daily practice. The cost of performing with a perilunate dislocation is the requirement to wear support in order to prevent any further damage. As athletic trainers we will be observing the sign of permulate dislocation which is a slight dislocation in the carpals. This injury is extremely rare in athletics and their is a huge chance that we might not get to observe this injury for ourselves. On the bright side, if we see this injury we could spot it right away with this information granted to us. To further get more information about this injury, we need to look at x- rays and how the injury progresses over time. To further have more knowledge about this injury, we need more research. (Waugh, 2009)

Work Cited:
Waugh, A.M., Johnson D.L., Branam B., Madaleno J.A., Boland M., and University of Kentucky (2009). Perilunate Dislocation in a Collegiate Football. Athletic Therapy Today, 14(1), 41-13.

Perilunate Dislocations. (n.d.). - Wheeless' Textbook of Orthopaedics. Retrieved March 19, 2014, from http://www.wheelessonline.com/ortho/perilu.

Trans-scaphoid perilunate dislocation. (2011, February 28). YouTube. Retrieved March 19, 2014, from https://www.youtube.com/watch?v=m1KzlJSYGPw.