What is the initial treatment for a perilunate dislocation?

Perilunate dislocations are typically characterized by the dislocation of the lunate bone in relation to the distal radius, often accompanied by a potential disruption of the carpal ligaments and surrounding structures. The initial treatment for this type of injury aims to restore proper alignment of the bones and minimize the risk of long-term complications, such as vascular compromise or chronic pain.

Closed reduction is the appropriate initial treatment because it involves repositioning the dislocated lunate back into its proper anatomical position without the need for surgical intervention. This method can often be performed with sedation or under local anesthesia in a clinical setting. After achieving the reduction, it is essential to secure the joint, monitor for any associated injuries, and assess vascular status.

Other options, such as physical therapy, medication, and rest with ice, are not suitable first-line treatments for a perilunate dislocation. These methods do not address the urgent need to correct the dislocation and can lead to increased complications if the dislocation is not promptly reduced. Therefore, the aim of closed reduction is to realign the dislocated bones effectively, which is critical for restoring function and preventing further injury.