Case 9

This 35 year old female was in a motor vehicle crash. She presents with severe pain and limitation of wrist movement. She is very tender on the dorsal aspect of her wrist. There is normal sensation and capillary refill distally. Her radiograph is shown below.

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The likely cause of her pain is:
A fractured triquetrum
A fractured hamate
A perilunate dislocation
A dislocated lunate