Perilunate injuries with lunate extrusion are extremely rare, representing an extreme subgroup of the Mayfield type 4 spectrum, with prognosis and management remaining controversial. We present a 45-year-old man with an open type 4 perilunate fracture dislocation, with lunate extrusion through the volar skin. Despite emergent treatment with open reduction and internal fixation, lunate and scaphoid proximal pole avascular necrosis developed. However, the overall functional outcome was satisfactory for daily activities at 30 months follow-up, with substantial improvement in the range of motion after hardware removal. To our knowledge, this is the third reported case of an open perilunate injury with lunate extrusion in the literature.
Case Rep Orthop Res 2021;4:210–216

中文翻译：

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月骨挤压开裂周缘骨折脱位病例报告及文献复习

月骨挤压引起的周围损伤极为罕见，代表 Mayfield 4 型谱的一个极端亚组，预后和治疗仍存在争议。我们介绍了一名 45 岁男性，患有开放性 4 型月骨周骨折脱位，月骨通过掌侧皮肤挤压。尽管进行了切开复位内固定的紧急治疗，但仍发生了月骨和舟状骨近端缺血性坏死。然而，在 30 个月的随访中，日常活动的总体功能结果令人满意，去除硬件后的运动范围得到了显着改善。据我们所知，这是文献中第三例报道的月骨膨出的开放性月周损伤病例。
案例代表 Orthop Res 2021；4:210–216