Wrist Dislocation in Emergency Medicine Follow-up
- Author: Michael S Beeson, MD, MBA, FACEP; Chief Editor: Rick Kulkarni, MD more...
Further Inpatient Care
Admission is not indicated for isolated wrist dislocation.
Further Outpatient Care
- Patients with lunate or perilunate dislocations, if reduced in the ED, may safely be discharged home with careful warnings of the potential for compartment syndrome, pain, and other postinjury conditions.
- Close follow-up must be arranged with a hand specialist.
Inpatient & Outpatient Medications
Because of the severity of pain, narcotic pain medication often is required for the first 3 days.
Transfer
Transfer is required if the emergency physician is unable to achieve reduction and a hand specialist is not available to evaluate the injury.
Complications
- Vascular complications are unusual but may occur if an associated fracture is present, particularly of the distal radius.
- Soft-tissue complications include carpal ligamentous disruption, which results in carpal instability.
- Kienbock disease, avascular necrosis of the lunate, may occur following lunate dislocations, even if there is successful reduction in the ED.
Prognosis
- Many patients who sustain lunate or perilunate dislocation develop chronic wrist pain or wrist instability.
- Remember that lunate and perilunate dislocations are part of a continuum of injury that arises from significant carpal ligamentous injury. This often results in chronic carpal instability.
Patient Education
For excellent patient education resources, visit eMedicine's Breaks, Fractures, and Dislocations Center. Also, see eMedicine's patient education article, Wrist Injury.
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