Lunate fracture patterns are classified into 4 stages based on radiographic findings. Stage I demonstrates no significant radiographic changes. In stage II, some degree of bone fragmentation is present without evidence of collapse. In stage III, fragmentation and collapse are observed. Stage IV demonstrates evidence of fragmentation, collapse, and arthritis.
Treatment of lunate fractures varies according to the stage of the disease. Most treatment options revolve around stress reduction, revascularization, or replacement of the lunate. Salvage procedures are reserved for advanced disease. Treatment options for stage I include no treatment or immobilization. The remaining stages are surgically treated with a variety of techniques. In stages II and III, the treatment options are surgical and include stress reduction, revascularization, and lunate replacement. Stage IV is also treated surgically with salvage procedures, such as scaphocapitate arthrodesis, total wrist arthrodesis, or proximal row carpectomy.
Carpal fractures can be among the most challenging orthopedic injuries to evaluate. Because no single treatment modality ensures an acceptable result for all carpal fractures, the treating physician must possess the knowledge and skill necessary to achieve an acceptable anatomic outcome. If diagnosed promptly and treated appropriately, the vast majority of these fractures will heal. The early establishment of anatomic alignment provides the best opportunity for the later recovery of wrist motion and function
In your case surgery seems to be the option.
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