Perilunate Dislocations Treated with External Fixation and Percutaneous Pinning

Savvidou, Olga D.; Beltsios, M.; Sakellariou, Vasileios I.; Papagelopoulos, Panayiotis J.

doi:10.1055/s-0035-1550159

Cited by 12 publications

(6 citation statements)

References 16 publications

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“…However, this technique has yielded unsatisfactory functional outcomes. Thus, polytrauma patients with accompanying ipsilateral extremity fractures, when swelling prevents casting the wrist, or elderly neglected unreduced perilunate dislocations, are the key indications for ligamentotaxis [ 18 ]. In all other situations, it appears that early surgical therapy and open reduction are the best options for the wrist.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Palmar Lunate Dislocation and Posterior Elbow Dislocation With a Distal Radius Fracture: A Rare Case Report

Jelti,

Barzouq,

El Alaoui

et al. 2024

Cureus

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We present an unusual case involving the simultaneous dislocation of the trans-scapho-retro-lunate in the right wrist and a posterolateral dislocation in the right elbow joint with a distal radius fracture in a 23-year-old male with no notable medical history. These injuries occurred when he fell from a height of around 12 meters onto his outstretched right hand. The patient presented to the hospital in a normal upper limb trauma position with no discomfort to critical functions. Predominant symptoms at the emergency department were discomfort in the right wrist, hand, and ipsilateral elbow, as well as the entire upper limb functional impairment. Both the wrist and the elbow seemed distorted on examination, with considerable edema and loss of bone landmarks. Passive mobilization was hampered by pain, but peripheral pulses were detectable. The radial, ulnar, and median nerves' autonomous sensory-motor domains were intact, with a cutaneous opening classified as stage 2 by the Cauchoix-Duparc classification. The elbow dislocation was successfully treated using a closed reduction method. External manipulation was employed to reduce the trans-scaphoid perilunate dislocation, which was subsequently stabilized through percutaneous screw fixation of the scaphoid using a triquetrum-lunate pin. Additionally, a styloid pin was utilized to address and manage a distal radius fracture, followed by the implementation of a radiometacarpal external fixator. After one year and three months, the patient reported no pain in his elbow and minimal wrist discomfort during heavy lifting.

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Section: Discussionmentioning

confidence: 99%

Concurrent Palmar Lunate Dislocation and Posterior Elbow Dislocation With a Distal Radius Fracture: A Rare Case Report

Jelti,

Barzouq,

El Alaoui

et al. 2024

Cureus

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“…Treatment of volar lunate dislocations with closed reduction and percutaneous K-wire fixation has shown acceptable functional outcomes [ 5 , 6 ]. Recent literature has also explored ligament reconstruction as an alternative [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Dorsal lunate dislocation and en bloc proximal row carpectomy: a case report

Campano,

Rush,

Gottlich

et al. 2024

Journal of Surgical Case Reports

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An unhelmeted 59-year-old male involved in a motorcycle accident presented with a right dorsal lunate dislocation in the context of a polytrauma evaluation. Soft-tissue attachments were minimal across the carpus, which allowed for an en bloc proximal row carpectomy. Two-year follow-up yielded a satisfactory outcome given the high energy injury mechanism. Proximal row carpectomy is a useful tool which preserves wrist range of motion in the acute trauma setting and is durable, as demonstrated by our patient’s postoperative mobilization using a wheelchair.

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“…A retrospective cohort study of 20 patients who presented with an acute perilunate dislocation or perilunate fracture-dislocation were treated with external fixation and Kirschner wires. 38 At a mean follow-up of 39 months, the flexion-extension arc of the injured wrist averaged 80% and 88%, respectively, of the contralateral wrist and 15 patients returned to their former occupation. 38 However, two patients developed nonunion of the scaphoid, and two developed post-traumatic arthritis of the carpus.…”

Section: Forearm and Wristmentioning

confidence: 92%

“…38 At a mean follow-up of 39 months, the flexion-extension arc of the injured wrist averaged 80% and 88%, respectively, of the contralateral wrist and 15 patients returned to their former occupation. 38 However, two patients developed nonunion of the scaphoid, and two developed post-traumatic arthritis of the carpus. 38 Perilunate injuries are uncommon and devastating, although external fixation may be a means of acutely managing this pathology.…”

Section: Forearm and Wristmentioning

confidence: 92%

See 1 more Smart Citation

The Role of External Fixation in the Management of Upper Extremity Fractures

Moses

Tejwani

2023

J Am Acad Orthop Surg

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External fixation is a powerful tool in the armamentarium of the active orthopaedic surgeon. The upper extremity, however, poses unique challenges in the techniques of external fixation because of the smaller soft-tissue envelope and the proximity of neurovascular structures, which may be entrapped in fracture fragments or traversing in line with pin trajectories. This review article summarizes the indications, techniques, clinical outcomes, and complications of external fixation of the upper extremity in the setting of proximal humerus, humeral shaft, distal humerus, elbow, forearm, and distal radius fractures.

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Perilunate Dislocations Treated with External Fixation and Percutaneous Pinning

Abstract: IV.

Cited by 12 publications

References 16 publications

Concurrent Palmar Lunate Dislocation and Posterior Elbow Dislocation With a Distal Radius Fracture: A Rare Case Report

Concurrent Palmar Lunate Dislocation and Posterior Elbow Dislocation With a Distal Radius Fracture: A Rare Case Report

Dorsal lunate dislocation and en bloc proximal row carpectomy: a case report

The Role of External Fixation in the Management of Upper Extremity Fractures

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