Lunate fractures and associated radiocarpal and midcarpal instabilities: a systematic review

Shunmugam, Meenalochani; Phadnis, Joideep; Watts, AC; Bain, Gregory I.

doi:10.1177/1753193417740850

Cited by 13 publications

(8 citation statements)

References 36 publications

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“…(2019) stated, in their CBCT study of patients with wrist pain and normal radiographs, that the trapezium is the most common radiographically occult radiocarpal fracture. Lunate fractures are described in the literature as rare, comprising 0.5–1% of all carpal fractures and when they are found, they are usually part of a more complex fracture pattern with concomitant fractures, of other carpal bones or the distal radius, and ligament injuries leading to midcarpal instability ( Shunmugam et al., 2018 ). Our study adds information on the existence of isolated lunate fractures, which comprised 8% of the carpal fractures found during the CBCT period.…”

Section: Discussionmentioning

confidence: 99%

Cone-beam computed tomography for primary investigation of wrist trauma provides a new map of fractures of carpal bones

Krayem

Lensing

Fornander

2021

J Hand Surg Eur Vol

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In 2016, our primary modality for radiological examination of wrist trauma, was changed from radiography to cone-beam computed tomography (CBCT). This is a retrospective survey of carpal bone fractures detected by CBCT during 6 months in 2016/2017, compared with those found on conventional radiographs during 6 months in 2013/2014. The incidence of carpal fractures was three times higher during the CBCT period (92/100,000 per year) compared with the radiography period (29/100,000 per year) and the spectrum of anatomical locations was different between the two periods, with fractures of the lunate ( n = 6), trapezium ( n = 9), trapezoid ( n = 4) and capitate ( n = 1) detected by CBCT, in contrast to no fractures of these bones diagnosed during the 6 months radiography period. We suggest a more liberal use of CBCT for examination of wrist trauma considering the benefits of being able to give patients a correct primary diagnosis, treatment and prognosis. Level of evidence: III

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Section: Discussionmentioning

confidence: 99%

Cone-beam computed tomography for primary investigation of wrist trauma provides a new map of fractures of carpal bones

Krayem

Lensing

Fornander

2021

J Hand Surg Eur Vol

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“…Fracture typically occurs together with other carpal fractures, perilunate dislocations, or ligament disruptions. Closed treatment with prolonged cast immobilization for 6 weeks for undisplaced lunate fractures is the recommended form of treatment [5]. Early surgical intervention with K wire or screws after good anatomical reduction reduces the risk of developing osteonecrosis in displaced lunate fractures [5].…”

Section: Discussionmentioning

confidence: 99%

A Very Rare Fracture: Isolated Fresh Lunate Fracture

Karslıoğlu

Keskin

Ocak

et al. 2021

Case Rep Orthop Res

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Lunate fractures are rare and usually occur together with other fractures, dislocations, or ligament disruptions. We want to report an acute fresh isolated lunate fracture without additional ligamentous injury fixated with early surgical intervention. A 23-year-old right-hand-dominated male patient was admitted to our hospital after falling from 1.5-meter ladder over right hand’s palmar face. Standard radiographs diagnosed a displaced lunate fracture. In the intraoperative evaluation, it was observed that there was only lunate dislocation, and there was no ligament lesion or other carpal bone pathology. Fracture was fixed with a headless cannulated screw. Radiographs showed bony union at 6-week follow-up. There was no evidence for Kienböck’s disease 6 months after surgery. Case report regarding fresh isolated lunate fracture that results in clinical success with early intervention without developing avascular necrosis as in our report is extremely rare. In conclusion, satisfying results can be obtained in these patients with careful surgical intervention.

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“…He found that volar dislocation at the midcarpal joint (14 out of 34 cases) is more common than dorsal dislocation (4 out of 34 cases). 8 In the traditional perilunate injury without a lunate fracture, dislocation in a dorsal direction is the most common. 9 In our three cases, all of the lunate fractures demonstrated a similar pattern, which resembled the Theissen type-I fracture pattern, that is, a coronal fracture at the volar lip.…”

Section: Discussionmentioning

confidence: 99%

Three Cases of Translunate Perilunate Injury Treated with Wrist Arthroscopy

Chow

2020

J Wrist Surg

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Background An acute fracture of the lunate is an uncommon injury with the reported incidence ranging from 0.5 to 1% of all carpal bone fractures. The combination of lunate fracture and perilunate injury is even rarer and Bain et al first introduced the “translunate arc concept” in 2008. We reported three cases of translunate perilunate injury treated with wrist arthroscopy. Materials and Methods All the three cases had been treated successfully with the use of wrist arthroscopy. A novel technique of arthroscopic reduction and fixation of a volar pole of lunate fracture was illustrated. The lunate fracture healed in all cases with normal carpal alignment. Results All patients achieved a painless and functional joint with good range of motion at an average follow-up of 15 months. There was no radiological evidence of avascular necrosis of the lunate in all three cases. Conclusion Translunate perilunate injury is rare and a high index of suspicion is necessary for diagnosis. There was no consensus on the surgical approach to this kind of injury. Wrist arthroscopy had proven to be successful in treating the greater and lesser arc perilunate injury. For translunate perilunate injury, wrist arthroscopy is also a feasible option with the advantages of lower risk of arthrofibrosis and avascular necrosis.

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Lunate fractures and associated radiocarpal and midcarpal instabilities: a systematic review

Cited by 13 publications

References 36 publications

Cone-beam computed tomography for primary investigation of wrist trauma provides a new map of fractures of carpal bones

Cone-beam computed tomography for primary investigation of wrist trauma provides a new map of fractures of carpal bones

A Very Rare Fracture: Isolated Fresh Lunate Fracture

Three Cases of Translunate Perilunate Injury Treated with Wrist Arthroscopy

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