In complete dislocations of the lunate, the displacement is usually in a palmar direction. The greater force required to produce this injury is responsible for massive disruption of both the dorsal and palmar ligaments.
The capitate displaces proximally towards the distal radial articular surface. A lateral radiograph shows the “spilled teacup” configuration of the lunate.
On the AP view, the displaced lunate has a triangular profile, rather than its normal quadrilateral image.
These are very difficult to manage operatively and nonoperatively. Most will go to have a failure of the ligament repair and will go on to develop some osteoarthritis of the wrist.