Perilunate Injuries, Not Dislocated (PLIND)

Herzberg, Guillaume

doi:10.1055/s-0033-1358548

Cited by 41 publications

(39 citation statements)

References 17 publications

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“…The delay between the injury and the treatment averaged 3 days. [1][2][3][4][5][6][7] All patients but one were male. Their mean age was 33 years (range 19-67).…”

Section: Methodsmentioning

confidence: 99%

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The Role of Arthroscopy for Treatment of Perilunate Injuries

et al. 2015

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Background?Open reduction with internal fixation (ORIF) is currently the gold standard treatment of acute perilunate injuries (PLIs). Less invasive surgery, including arthroscopic techniques, has recently emerged in the hope that results similar to those of ORIF could be obtained with less tissue disturbance. Our purpose was to review retrospectively a series of selected PLIs treated with arthroscopic assistance over the past 10 years. Materials and Methods?Between 2004 and 2014, a total of 135 acute PLIs were surgically treated in our unit. A total of 27 patients were treated with arthroscopic assistance, among whom 18 were reviewed clinically and radiologically. Description of Technique?After an initial closed gross reduction, radio- and midcarpal arthroscopy were performed to clean up the debris and assess the cartilaginous, bony, and ligamentous damage. In 22 cases arthroscopy was followed by either radiolunate and lunotriquetral pinning, scapholunate ligament repair, and SL joint pinning or ORIF of a scaphoid fracture through a mini-invasive dorsal approach. In the remaining six cases, fixation of the ligamentous and/or bony injuries was done using arthroscopy alone. Results?Arthroscopic findings are presented as well as the clinical results in a subgroup of patients. At final follow-up, visual analog scale (VAS) pain was rated 18/100 on average (minimum 0, maximum 50). If we consider only the patients without reflex sympathetic dystrophy (RSD; n?=?14), the average active wrist flexion-extension was 87? (58% of the normal contralateral side) and the average grip strength was 30?kg (71% of the normal contralateral side). Conclusions?Although no statistical comparisons were made, we found that the results were similar to those of ORIF. The results of our study suggest that the use of arthroscopy to treat selected PLIs may be a reliable adjunct either alone or in combination with a dorsal mini-open approach.

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“…The delay between the injury and the treatment averaged 3 days. [1][2][3][4][5][6][7] All patients but one were male. Their mean age was 33 years (range 19-67).…”

Section: Methodsmentioning

confidence: 99%

“…Only perilunate injuries not dislocated (PLIND), dorsal perilunate dislocations (PLD), and/or dorsal perilunate fracture-dislocation (PLFD) stage 1 or 2A according to our modified PLI classification 7 were eligible for arthroscopic treatment.…”

Section: Methodsmentioning

confidence: 99%

The Role of Arthroscopy for Treatment of Perilunate Injuries

et al. 2015

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“…We use dry wrist arthroscopy combined with automatic wash outs (AWO) to evacuate the bone debris. 10,11 We first prepare the three-portal ARS here(►Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

Isolated Arthroscopic Radial Styloidectomy: The Three-Portal Approach

Herzberg

Burnier

2020

J Wrist Surg

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Background The current gold-standard technique for radial styloidectomy is arthroscopic. The use of only two dorsal portals may not allow a crystal-clear view of the dorsal arthritic rim of the radius because of the dorsal capsule synovitis. Objectives To propose a new technique for isolated arthroscopic radial styloidectomy. The addition of a volar radial portal and a sequential procedure are presented. Patients and Methods Two trochars for alternatively viewing from volar radial or 3–4 are used. A 1–2 portal is used for instrumentation with a motorized burr. We have been using the three-portal technique in 34 cases (26 isolated). Results This modification of the classic arthroscopic radial styloidectomy is technically easy and the view of the dorsal rim of the radius provides a clear definition and treatment of the dorso-radial arthritic pathology. Conclusions The authors recommend this technical trick to perform an easy and comprehensive isolated palliative or curative arthroscopic radial styloidectomy.

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“…[12] • Nondisloke perilunat yaralanmalar: Bu yaralanmalar sonraki dönemde el cerrahisine ihtiyaç duyar. [13] • Skafoid kırıkları : % 13 oranında atlanan ve standart grafilerde % 20 oranında normal bulunan kırıklardır ve bazen yanlış teknikle çekilen BT de bile atlanabilir. [14] • Posterior omuz çıkığı: Çok nadir görülen bir çıkık olup dikkatli muayene edilmezse grafilerde normal olarak görülebilir.…”

Section: üSt Ekstremi̇teni̇n Gözden Kaçan Kiriklariunclassified

Evaluation of Overlooked Fractures - Dislocations and Trauma Series

başal¹

2015

Orthopaedics and Sports Medicine Guide for Researchers

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Atlanmış kırık nedir? Missed Diagnosis? Overlooked Fractures?Hastanın ilk muayenesinde tanı konulmayan ama daha sonraki muayenelerinde, rehabilitasyon esnasında veya taburcu sonrası fark edilen yaralanmalar atlanmış kı-rık olarak tanımlanmaktadır. Atlanan kırıkların anatomik yerleşimlerine bakıldığında, bazı kırık türlerinin gözden kaçabileceği unutulmamalıdır. Bu konuda hekimin uyanık olması ve buna göre bir sistematik yol haritası belirlemesi bu tür sorunların yaşan-masına engel olacaktır. Bilinç kapalı ya da ağrıyı lokalize edemeyecek koopere olamayan vakalarda fizik muayenenin bazı basamakları eksik kalabilir. Nörojenik şok, hipoaljezi, parestezi, parapleji gibi durumlarda hasta ağrıyı lokalize edemeyebilir. Palpasyonda hassasiyetin olmadığı ve daha henüz ekimoz, yumuşak doku şişliğinin belirginleşmediği travmanın ilk saatlerinde bazı kırık ya da çıkıkları atlamak işten değildir. Bunu bir malpraktis olarak görmektense ikincil bakının ne kadar önemli olabileceğine vurgu yapmakta yarar vardır. Nasıl ki nörolog ya da nöroşirürjiyen belli aralıklarla muayene bulguları-nı kontrol ediyorsa bizim de nörolojik muayenedeki değişikliklere paralel olarak travmalı hastayı tekrar tekrar muayene etmemiz gerekir. Diğer bir husus ise öncelikle biz ortopedistlerin normal ya da normalin varyantlarını çok iyi bilmemiz gerektiğidir.

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Perilunate Injuries, Not Dislocated (PLIND)

Cited by 41 publications

References 17 publications

The Role of Arthroscopy for Treatment of Perilunate Injuries

The Role of Arthroscopy for Treatment of Perilunate Injuries

Isolated Arthroscopic Radial Styloidectomy: The Three-Portal Approach

Evaluation of Overlooked Fractures - Dislocations and Trauma Series

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