Pain in wrist following fall from bike.
Malalignment of the lunate bone (piece of pie sign) suggesting lunate being tilted volarly.
Radial styloid fracture.
Diagnosis: Lunate dislocation
- Stage 4 of perilunate injury.
- Mechanism: forced dorsiflexion of the hand, resulting in injured ligaments (especially dorsal radiolunate ligament).
- Can become an orthopedic emergency as the volarly tilted lunate can compress the nerves and arteries running through the palmar surface.
- Need urgent reduction and surgical repair of the torn ligament.
Lunate dislocation, radiopaedia.org