Peri-lunate dislocation and fracture-dislocation of the wrist: Retrospective evaluation of 65 cases

Orthopaedics & Traumatology, Surgery & Research : OTSR
D IsraelP Mansat

Abstract

Peri-lunate wrist dislocations and fracture-dislocations are related to high-energy trauma. Prognosis is often compromised because of the complexity of the lesions. The purpose of this study was to assess outcomes of acute peri-lunate injuries and correlate them with the type of lesion and management. A monocenter retrospective study has been conducted. Sixty-five patients (65 wrists) were reviewed. According to Herzberg's classification, there were 18 isolated peri-lunate dislocations and 47 peri-lunate fracture-dislocations - 27 with a scaphoid fracture and 20 with an intact scaphoid. The displacement was dorsal in 62 cases. All patients were treated surgically. At an average follow-up of 8 years (2-16) the average Cooney score was 66 points, quick-DASH score 21 points, and PRWE score 28 points. Pain score was 1.3 out of 10 points at rest and 4.3 out of 10 with effort. The flexion-extension arc was 96° with an average strength of 38kg (70±23% of opposite side). Radiographic analysis has shown decrease in carpal height, increase in ulnar translation, and DISI. Sign of wrist arthritis was found in 58.5% of the cases. The rate of osteonecrosis was 7.7%. Regional sympathetic painful syndrome was observed in 12%. In 26% of the cas...Continue Reading

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Citations

Feb 9, 2017·Clinics and Practice·Bong-Sung KimNorbert Pallua
Aug 3, 2021·British Journal of Hospital Medicine·Madeleine GarnerPhilip Mathew
Aug 24, 2021·Geriatric Orthopaedic Surgery & Rehabilitation·Guy RubinNimrod Rozen

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