In lunate or perilunate dislocations, what complication is of primary concern due to neurovascular compromise?

In lunate or perilunate dislocations, what complication is of primary concern due to neurovascular compromise?

• A. Median Nerve Palsy
• B. Avascular Necrosis
• C. Osteoarthritis
• D. Tendon Rupture

Answer: (B)

The critical idea is that the lunate’s blood supply is easily disrupted when the wrist undergoes a lunate or perilunate dislocation. The lunate depends on small dorsal and volar arteries to stay viable; a dislocation can tear or compress these vessels, cutting off perfusion to the bone. If the lunate loses blood supply, it undergoes avascular necrosis, which can progress to bone collapse, wrist instability, chronic pain, and early arthritis. This vascular complication is the primary concern because it directly stems from the injury’s impact on blood flow. While nerve compression can occur and long-term issues like osteoarthritis or tendon rupture can follow, they are not the immediate consequence of disrupted vascular supply in these injuries.

The critical idea is that the lunate’s blood supply is easily disrupted when the wrist undergoes a lunate or perilunate dislocation. The lunate depends on small dorsal and volar arteries to stay viable; a dislocation can tear or compress these vessels, cutting off perfusion to the bone. If the lunate loses blood supply, it undergoes avascular necrosis, which can progress to bone collapse, wrist instability, chronic pain, and early arthritis. This vascular complication is the primary concern because it directly stems from the injury’s impact on blood flow. While nerve compression can occur and long-term issues like osteoarthritis or tendon rupture can follow, they are not the immediate consequence of disrupted vascular supply in these injuries.