A serious wrist dislocation that can go unnoticed
Insight from a hand surgeon and an emergency physician
A hard impact can shove the small bones of the wrist out of place around a bone called the lunate. Doctors call this a perilunate dislocation. The wrist may be swollen and hurt badly. Even so, the change in its shape can be hard to see. Broken bones can come with it as well. [1]
The injury can press on the median nerve, a main nerve that runs through the wrist. This may bring tingling or numbness in the thumb, index finger or middle finger. Doctors need to spot the injury fast. Delays in care can harm the nerve and how the joint works. [1]
Ask what your wrist X rays show
Your doctor checks the feeling, movement and blood flow in your fingers. Then they study X rays of the wrist with care. Sometimes more imaging helps show any broken bones that go with it. Were you told it was only a sprain? If the pain stays severe or your fingers go numb, get checked again urgently. Tell the team how hard the crash was and where your hand hit or braced. [1]
Putting the bones back and fixing the damage
The first job is to move the bones back to a safer spot and protect the nerve. Many people then need surgery to repair or steady the hurt structures. Doctors call putting the bones back a reduction. Afterward, ask if the joint is lined up. Find out whether the median nerve is getting better and what the planned surgery will fix. [1]
Follow your splint instructions closely. Getting back motion and grip usually takes a longer stretch of therapy. [1]
Signs that can't wait
Get emergency care if finger numbness is new or getting worse. Swelling or pain that ramps up fast is another reason to go. So is a hand that turns cold or pale. Do not force your wrist to move just to test it. [1]
Questions to ask about your wrist
- Did you check all the wrist bones and look for nearby fractures?
- Is my median nerve involved?
- What repair and rehab should I expect?
When the diagnosis is still unclear
If your wrist hurts badly and no one has given you a clear diagnosis, ask to see a hand specialist. [1]
Sources and further reading
This piece offers general education from hand surgery and emergency medicine. A perilunate injury needs an exam in person plus imaging. Never try to move the wrist bones back into place yourself.
Keep learning
Safe Driving Resource Center
Guides, self-checks and articles for drivers, parents of new drivers, and families recovering after a crash.
