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Mayfield described four stages of perilunate instability. The first stage (I) is disruption of the scapholunate articulation. The second (II) and third (III) stages are separation of the capitolunate and lunotriquetral joints. The fourth (IV) stage is a volar lunate dislocation (with permission from Mayfield JK. Wrist ligamentous anatomy and pathogenesis of carpal instability. Ortho Clin North Am 1984;15(2):209–216)
