Introduction: Perilunate dislocations are rare and high-energy proximal carpal row injuries that are associated with long-term disability. The current accepted pathomechanism of this injury is progressive radial to ulnar intrinsic ligament tearing, as described by Mayfield in 1980. Since his description several other ligaments have been described as critical stabilizers of the proximal carpal row.
Purpose: To achieve perilunate instability in a biomechanical model and evaluate integrity of recently described carpal ligamentous stabilizers.
Methods: We tested six fresh-frozen cadaveric upper extremities and loaded them to failure in extension, ulnar deviation and carpal supination using a previously validated three-point load to failure model.
Results: We were not able to achieve any carpal instability in our specimens using our biomechanical model.
Conclusions: Carpal dislocations are a complex phenomenon that cannot be entirely explained by previously defined mechanisms.
