Perilunate fracture-dislocations: clinical and radiological results of 21 cases

Mészáros, T; Vögelin, Esther; Mathys, L.; Leclère, Franck Marie

doi:10.1007/s00402-017-2861-1

Cited by 24 publications

(9 citation statements)

References 26 publications

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“…The outcomes of PLD and PFLD surgical treatment have been reported by other authors. 6,[14][15][16][17] In most reports, the radiographic outcomes of PLD/PLFD were satisfactory, while the clinical outcomes were less satisfactory. In particular, the postoperative wrist ROM and function were compromised considerably.…”

Section: Limitations and Future Perspectivesmentioning

confidence: 99%

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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Section: Limitations and Future Perspectivesmentioning

confidence: 99%

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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“…Ligamentous injury surrounding the lunate may cause an acute interruption of vascular supply and compromise intraosseous circulation of the lunate. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Coll reported a case of palmar dislocation of the scaphoid and lunate, which subsequently resulted in lunate avascular necrosis (AVN). 25 Manohara et al described a case of AVN involving the scaphoid, lunate, and triquetrum following an isolated perilunate dislocation (PLD) of the wrist.…”

Section: Ligamentous Injury and Acute Vascular Compromise Of The Lunatementioning

confidence: 99%

Kienböck Disease following a Single Wrist Traumatic Incident: A Scoping Review

Afshar,

Tabrizi,

Shariyate

2024

J Wrist Surg

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The incidence of Kienböck disease after a single wrist traumatic incident is rare but has been reported by several authors. Although most evidence consists of case reports and case series, two possible concerns have been suggested. First, a traumatic alteration of the wrist anatomy and measurements increase stresses on the lunate. These changes mostly follow fractures around the wrist and can be regarded as acquired risk factors that contribute to the development of Kienböck disease. Second, some wrist injuries may tear ligaments around the lunate and damage the accompanied blood vessels; so, compromising the circulation to the lunate. Surgeons should be aware of the development of Kienböck disease following a single wrist trauma to enable early diagnosis and management to improve outcomes. Level of evidence Etiology IV.

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“…This data is troublesome, since early diagnosis and treatment are critical to minimize serious complications such as stiffness, chronic pain and posttraumatic arthrosis. 2,4,7,8 In addition, treatment delay was shown to negatively impact the final outcome. 6,9 This reality reported by international studies does not seem to be different from the Brazilian reality.…”

Section: Introductionmentioning

confidence: 99%

“…1 2 Em um estudo multicêntrico com 166 pacientes, Herzberg et al 6 demonstraram que em 25% dos casos o diagnóstico não foi realizado na avaliação inicial, tanto nas luxações simples como nas fraturas-luxações transescafoperilunares. Esse dado é preocupante pois o diagnóstico e tratamento precoce é fundamental para minimizar complicações graves como rigidez, dor crônica e artrose pós-traumática, 2 4 7 8 e o atraso no tratamento comprovadamente afeta de forma negativa o resultado final. 6 9 …”

Section: Introductionunclassified

Índice de falha diagnóstica na detecção de fraturas e luxações perilunares do carpo utilizando radiografias simples do punho

Tanure

Andrade

Rezende

et al. 2020

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivos O presente estude teve como objetivo avaliar o índice de falha diagnóstica na detecção de fraturas e luxações perilunares do carpo utilizando radiografias simples do punho por ortopedistas e residentes de ortopedia. Secundariamente, identificar possíveis grupos que apresentem maior ou menor chance de acerto diagnóstico. Métodos Foi aplicado um questionário online a diversos ortopedistas através de e-mail, redes sociais e aplicativos de comunicação via smartphone, para avaliar o índice de falha diagnóstica na detecção de fraturas e luxações perilunares utilizando radiografias simples. Resultados Foram obtidas 511 respostas e observado um índice de erro diagnóstico de 8,81% para as luxações simples e 1,76% para fratura transescafoperilunar. Ao estratificar por grupos, os médicos residentes obtiveram os maiores índices de erro nas luxações perilunares simples (23,91%), já os cirurgiões de mão obtiveram os índices mais baixos (1,74%). Conclusão Ao comparar com a literatura, os índices de falha encontrados foram menores, sugerindo que a radiografia simples é eficaz e que o índice de erro pode não ser tão elevado quanto o relatado na literatura.

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Perilunate fracture-dislocations: clinical and radiological results of 21 cases

Abstract: This retrospective study demonstrates good functional results despite the high rate of radiological wrist arthritis. Age, length of follow-up, and loss of reduction were significantly associated with wrist arthritis in our series.

Cited by 24 publications

References 26 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

Kienböck Disease following a Single Wrist Traumatic Incident: A Scoping Review

Índice de falha diagnóstica na detecção de fraturas e luxações perilunares do carpo utilizando radiografias simples do punho

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