Perilunate carpal dislocation. Clinical evaluation of patients operated with reduction and percutaneous fixation without capsular-ligament repair

Abstract

ObjectiveTo qualitatively assess surgeries performed in patients with perilunate dislocations without associated fractures, who were operated using the closed reduction and percutaneous fixation method. The follow-up time ranged from one to seven years.Methods628 patient records with traumatic wrist injuries, operated by the same group of Hand Surgeons between 2008 and 2014 due to acute trauma were collected, with a mean follow-up of 3.2 years. Of these, 51 were cases of perilunate fracture-dislocations, and 38 were pure perilunate dislocations without associated fractures; of these, only 32 underwent percutaneous fixation without ligamentous repair, thus meeting the inclusion criteria. Of the nine patients with perilunate dislocations who were treated using the closed reduction and percutaneous fixation method, whose mean age was 38 years (range 26–49 years), the dominant side was the left in two-thirds of the cases, and the predominant trauma mechanism was direct trauma.ResultsThis study is in agreement with the literature, showing that cases treated early present good results.Conclusion88% of patients who were treated by closed reduction and percutaneous fixation method maintained their daily activities and were assessed as excellent or good by the Clinical Scoring Chart.

Outcomes of Perilunate Dislocation and Perilunate Fracture Dislocation After a Minimum 1-Year Follow-Up Following Open Reduction and Internal Fixation Via the Dorsal Approach: A Retrospective Study

“…Open reduction offers the advantage of realigning the bone to its anatomical position and repairing of the ligaments. However, the techniques and outcomes of open reduction remain debatable (2)(3)(4)(5)(6)(7)(9)(10)(11)(12)(13) . In addition, complications such as joint stiffness and osteoarthritis of the wrist may arise from various treatments.…”

Perilunate Injury Timing and Treatment Options: A Systematic Review

“…Closed reduction without fixation has been attempted; however, it shows poor results and has high recurrence rate for the dislocation. [9][10][11][12] When irreparable damage to cartilage or bone is present, salvage procedures can be performed. Salvage treatment involves proximal row carpectomy (PRC), four-corner fusion, and wrist arthrodesis.…”