|A lunate fracture as seen on CT scan of the wrist|
|Symptoms||Wrist pain and swelling|
|Complications||Avascular osteonecrosis, wrist instability, arthritis|
|Types||Palmar pole, distal pole, transverse, osteochondral, transarticular body|
|Causes||Fall onto the hand|
|Diagnostic method||Plain X-rays, CT scan, bone scan, MRI|
|Differential diagnosis||Kienböck disease, congenitally bipartite lunate|
|Treatment||Not displaced: Casting|
|Frequency||0.5% to 4% wrist breaks|
Lunate fracture is a break of the lunate bone of the wrist. Symptoms may include pain to the back and front of the wrist and wrist swelling. Moving the wrist worsens symptoms. Complications may include avascular osteonecrosis, wrist instability, and arthritis.
The cause is often a fall onto the hand. Types include palmar pole, distal pole, transverse, osteochondral, and transarticular body. Diagnosis is typically confirmed by plain X-rays, CT scan, bone scan, or MRI. Other conditions that may appear similar include Kienböck disease and congenitally bipartite lunate.
Treatment of cases in which the bones remain well aligned is by orthopedic casting for 4 to 6 weeks. If the peices of bone are not well aligned or the dorsal aspect is broken, surgery is generally required.
Lunate fractures represent about 0.5% to 4% of breaks of bones within the wrist. It is less commonly than scaphoid, triquetrum, and trapezium breaks. The lunate was named by Lyser in 1653 and breakdown of the lunate was found at anatomic dissection before 1900.
Teisen classification is a system of categorizing lunate fractures.
|I||Volar pole fracture|
|II||Chip fracture not affecting the blood supply|
|III||Fracture of dorsal pole|
|IV||Sagittal fracture through the body|
|V||Transverse fracture through the body|
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