Perilunate fracture-dislocations: Clinical and functional outcomes at a mean follow-up of 3.3 years

Lebot, Gaspard; Amouyel, Thomas; Hardy, Alexandre; Chantelot, Christophe; Saab, Marc

doi:10.1016/j.otsr.2021.102973

Cited by 14 publications

(10 citation statements)

References 38 publications

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“…In the present study, the majority of patients (26 out of 30) had PLFD. These results were very similar to those of Lebot et al .,13 except for the rate of posttraumatic arthritis.…”

Section: Discussionsupporting

confidence: 91%

“…Lebot et al 13 reported the clinical and functional outcomes of PLFD in 10 patients with a mean follow-up of 3.3 yr. The mean flexion/extension of the involved wrist was 55% of the contralateral side.…”

Section: Discussionmentioning

confidence: 99%

“…Lebot et al 13. reported the clinical and functional outcomes of PLFD in 10 patients with a mean follow-up of 3.3 yr.…”

Section: Discussionmentioning

confidence: 99%

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Short-term outcomes of perilunate dislocations and perilunate fracture-dislocations: a single-center retrospective study

Shariatzadeh

Mazhar

Hosseinzadeh

2022

Current Orthopaedic Practice

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Background:Perilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD) are rare, but serious wrist injuries. This study reports the radiographic and clinical outcomes of PLD/PLFD in a series of 30 patients. Methods:Thirty patients with PLD (n = 4) or PLFD (n = 26) and a mean follow-up of 17.2 mo (range 12 to 21) were included in this retrospective study. Radiographic outcomes included the scapholunate angle, scapholunate interval, and carpal height ratio. Clinical outcomes included the wrist range of motion (ROM), pinch, and grip strength. Wrist function was assessed by a modified Mayo wrist score. Results:At the final follow-up, the scapholunate angle and interval were above the normal value in 10 and three patients, respectively. The carpal height ratio was normal in all patients. The mean wrist flexion was 44.2 ± 15.8 degrees. The mean wrist extension was 28.3 ± 15.4 degrees. The mean radial deviation was 14.3 ± 4.3 degrees. The mean ulnar deviation was 18.4 ± 6.3 degrees. The mean grip strength was 50.4 ± 11.6 lb. in the involved wrist and 54.6 ± 13.3 lb. in the noninvolved wrist (P = 0.27). The mean pinch strength was 9.1 ± 2.1 lb. in the involved wrist and 9.5 ± 1.8 lb. in the noninvolved wrist (P = 0.15). The mean modified Mayo score of the patients was 65.5 ± 10. Postoperative stiffness, pain, and carpal instability were observed in six, five, and nine patients, respectively. Conclusions:Surgical treatment of PLD/PLFD provides satisfactory radiographic outcomes. Clinical outcomes seem to be less satisfactory, even after prompt diagnosis and treatment.

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“…In the present study, the majority of patients (26 out of 30) had PLFD. These results were very similar to those of Lebot et al .,13 except for the rate of posttraumatic arthritis.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Short-term outcomes of perilunate dislocations and perilunate fracture-dislocations: a single-center retrospective study

Shariatzadeh

Mazhar

Hosseinzadeh

2022

Current Orthopaedic Practice

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“…Interpreting this injury as a more common perilunate fracture-dislocation would include internal fixation of presumed ligament injuries, prolonged immobilization/rehabilitation and reduced wrist function ( 10 ). Even after shorter follow-up, patients demonstrate complex recovery, residual problems and degenerative changes on radiographs ( 11 ). Similar results after 4–5 carpometacarpal-hamate fracture-dislocations are described.…”

Section: Discussionmentioning

confidence: 99%

Bilateral carpal pilon-type fractures due to clenched fist trauma: a case report

Reigstad¹,

Holm-Glad²,

Korslund³

et al. 2023

Ann Joint

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Background Multiple carpal fractures or fracture dislocations can be devastating to the wrist. Despite anatomical reduction and ligament reconstruction, reduced function and arthrosis is often observed. Simple fractures without ligament injuries often fare well if anatomy is restored and the fracture heals. Case Description A 17-year-old autistic man presented with pilon-type bilateral fractures of the carpals after crashing his bicycle in a car with clenched fists around his bicycle handlebars. He had a displaced scaphoid, minimal displaced capitate and an undisplaced hamate fracture on the left side and an undisplaced scaphoid and displaced two-part capitate fracture on the right side. The fractures were reduced and stable fixation with screws performed. He was immobilized for 2 weeks and allowed early active motion. At 8 weeks the fractures had healed, and he obtained good function. At final follow-up after 6 months his nearest of kin reported excellent function, he had returned to his preinjury activity level. Range of motion and grip-strength was excellent and symmetrical. Radiographs and CT scans revealed healed fractures in anatomical position, no sign of ligament injuries, carpal instability or arthrosis. Conclusions Multiple carpal fractures are not necessarily prone to reduced wrist function, pain and arthrosis, even in bilateral cases. If the ligaments are intact, stable fixation obtained and early mobilization obtained the fractures reduced and stable fixation obtained excellent hand and wrist function can be obtained.

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“…Median nerve symptoms and reduced sensory function may persist in 18% of patients years after initial injury (Dunn et al, 2018;Liechti et al, 2023). Manual laborers and those injured at work tend to have poorer outcomes and are less likely to return to their previous employment (Kremer et al, 2010;Lebot et al, 2021). Complications after surgery occur in about 15% of patients, with the majority due to nonunion or loss of reduction.…”

Section: Outcomes and Complicationsmentioning

confidence: 99%

Carpal dislocations

Heineman,

Do,

Golden

2023

J Hand Surg Eur Vol

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Carpal dislocations result from sequential disruption of the complex relationship between the bones and ligaments of the wrist. Injuries to the carpus occur via predictable mechanisms, an understanding of which is critical to identify and treat these frequently missed patterns of injury and to avoid the sequela of chronic instability. Lunate dislocations are by far the most common, but isolated dislocation of other carpal bones can also occur. Open reduction and internal fixation still remains the gold standard for treatment regardless of the debate around the specific approaches. These high-energy injuries are associated with significant long-term morbidity even when identified promptly and appropriately treated. This review will focus on the evaluation and management of common forms of carpal dislocations.

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Perilunate fracture-dislocations: Clinical and functional outcomes at a mean follow-up of 3.3 years

Cited by 14 publications

References 38 publications

Short-term outcomes of perilunate dislocations and perilunate fracture-dislocations: a single-center retrospective study

Short-term outcomes of perilunate dislocations and perilunate fracture-dislocations: a single-center retrospective study

Bilateral carpal pilon-type fractures due to clenched fist trauma: a case report

Carpal dislocations

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