Perilunate and Axial Carpal Dislocations and Fracture–Dislocations

Herzberg, Guillaume

doi:10.1016/j.jhsa.2008.09.013

Cited by 81 publications

(96 citation statements)

References 22 publications

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“…8,9 Some surgeons believe that PLDs and perilunate fracturedislocations (PLFDs) presenting in a delayed fashion have substantial risk of arthrosis and poorer clinical outcome. 3 Manipulative reduction and fabricating an orthosis doesn't always restore carpal alignment 2,3,10e15 and operative treatment is usually recommended.…”

mentioning

confidence: 99%

Perilunate Dislocations

Vitale¹,

Seetharaman²,

Ruchelsman³

2015

The Journal of Hand Surgery

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A 37-year-old man injured his right wrist in a motor vehicle collision. In the emergency department he had severe wrist pain and median nerve paresthesia. Wrist radiographs identified a dorsal perilunate dislocation (PLD) with the carpus dislocated dorsally and the lunate tilted volar but still located in the lunate fossa. Post-reduction computed tomography scan confirmed no fractures. THE QUESTIONSWhat is the optimal surgical approach for this patient with a purely ligamentous (i.e., "lesser arc" 1 ) dorsal PLD? What bones should be immobilized and what is the best method of internal fixation? CURRENT OPINIONPLDs are high-energy carpal injuries that result in wrist stiffness and arthrosis even if good carpal alignment is restored. 2e7 PLD merits urgent reduction when there is associated median nerve dysfunction, CME INFORMATION AND DISCLOSURESThe Review Section of JHS will contain at least 2 clinically relevant articles selected by the editor to be offered for CME in each issue. For CME credit, the participant must read the articles in print or online and correctly answer all related questions through an online examination. The questions on the test are designed to make the reader think and will occasionally require the reader to go back and scrutinize the article for details.The JHS CME Activity fee of $15.00 includes the exam questions/answers only and does not include access to the JHS articles referenced.

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mentioning

confidence: 99%

Perilunate Dislocations

Vitale¹,

Seetharaman²,

Ruchelsman³

2015

The Journal of Hand Surgery

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“…Open treatment of PLDs using dorsal or dorsal and volar combined incisions, for reduction and ligament repair have also shown poor results. 7,22,23 Hildebrand et al 24 performed an open reduction through a combined dorsal and volar approach on a mixed cohort of patients who sustained both PLDs and perilunate fracture dislocations (PLFDs). 24 Despite good Mayo scores and wrist range of movement they reported high complication rates and poor patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes following reduction and pinning of lesser arc injuries without repair of the scapholunate interosseous ligament

et al. 2017

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“…Die Unterscheidung zwischen dorsalen und palmaren perilunären Luxationen ist ohne praktische Bedeutung, da Letztere nach Gewalteinwirkung auf die flektierte Hand mit nachfolgender Luxation des Capitatums nach palmar nur sehr selten (3-5 %) vorkommen [4,17]. Auch bei einer Dislokation des Lunatums weit in die palmaren Weichteile hinein liegt eine dorsale perilunäre Luxation vor, sofern es sich nicht um eine ebenfalls sehr selten vorkommende isolierte Heraussprengung des Mondbeines im Sinne eines Direkttraumas handelt, die dann als Lunatumluxation zu bezeichnen ist.…”

Section: Klassifikationunclassified

Perilunäre Luxationen und Luxationsfrakturen an der Handwurzel

Dönicke

Friedel

Hofmann

2015

Trauma Berufskrankh

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Die perilunäre Luxation ist eine schwere und komplexe Handverletzung, die das Radiokarpal-und Mediokarpalgelenk sowie interkarpale Gelenke betrifft und hier zu einer Ruptur essenzieller Anteile des intrinsischen und extrinsischen Bandapparates und häufig auch zur Frakturierung der gelenkbildenden Knochen führt. Obwohl diese Luxationsform im klinischen Alltag ein relativ seltenes Ereignis ist, erfordern die korrekte Beurteilung des Verletzungsausmaßes und die daraus abzuleitenden Therapieentscheidungen fundierte Kenntnisse der anatomischen und biomechanischen Gegebenheiten an der Handwurzel, gleichzeitig aber auch fortgeschrittene handchirurgische Erfahrungen für die sachgerechte Versorgung.

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Perilunate and Axial Carpal Dislocations and Fracture–Dislocations

Cited by 81 publications

References 22 publications

Perilunate Dislocations

Perilunate Dislocations

Clinical outcomes following reduction and pinning of lesser arc injuries without repair of the scapholunate interosseous ligament

Perilunäre Luxationen und Luxationsfrakturen an der Handwurzel

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